Tag Archive | psychiatrist

better days to come

the month of June is coming to an end, and i think i can’t wait for a much better July.

3 lacerations (and consequently 2 surgeries by hand surgeons and another minor surgery by the emergency doctor), had wound dehiscence and wound infections (MRSA and Pseudomonas), was held overnight for observation twice in the psychiatric hospital, had currents three times, had lithium upped, and then all these while having school and a paper to submit. sigh.

just saw my psychiatrist today. stopped further currents. adjusted my medications (lithium level [1g] is at 0.9). continuing therapy. and then praying for the best.

i don’t think i can relive another June again.


 “My grace is sufficient for you for you, for my power is made perfect in weakness.” I will all the more gladly boast of my weaknesses, that the power of Christ may rest upon me. For the sake of Christ , then, i am content with weaknesses, insults, hardships, persecutions, and calamities; for when i am weak, then i am strong.

2 Corinthians 12-9,10

 

 

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the struggle

what a tragedy it is, that in recovery i am still struggling to live. a state of being deemed normal to others is a state of being too strange and uncomfortable. i seemed to have forgotten what it means to truly live. these 2.5 months have been good yet too surreal for me. everything seems strangely quiet. it’s so quiet it’s deafening in my head. i can’t sit easy. i struggle with the peace. why are things so calm? but despite all i try to celebrate my cut-free days. but it seems that i’m still very early in recovery attempt. he tells me that i can’t celebrate. not just yet. i’ve had better days- 7 months straight. and my psychiatrist can’t forget how hard i fell right after that. (he also couldn’t rule out the possibility that i may fall into depression yet again.) so in the meantime, i just have to hold on tight. normal is good. strange but good. and i would just have to settle with that, and learn that it will be ok.


everytime i see my rheumatologist or anaesthetist, i tell myself “this is it!”. i tell myself that this will be the consult that will make things all better again.  TEN years down the road, and it cannot be more untrue. there is no cure, no fix for all these chronic pain stemming from RA and fibromyalgia. nothing can truly make them go away. to wish that my doctors, however good they are, can make them go away, is unrealistic. and i am only being too hard on myself for asking to be rid of all the pain.

i begged my anaesthetist to take away all my fibro pain (at the least; my rheumy can take care of my joints). going through all my symptoms and then the list of medications he’s been giving me, there really wasn’t much he could give me. he kept all the medications the same, except that he increased the topiramate now to 50mg BD to help with the tension headaches. he was quite appalled by my usage of ergotamine, but i told him this was the state of my headaches. i decided not to get any trigger point injections or intra-articular injections because it’s been proven to be quite futile over the past few years. and i’ve told him i’ll be continuing with physiotherapy, but will be stopping acupuncture. i walked out of the consultation room heavy-hearted. as usual, nothing could be done. i am going to have to live with the debilitating back pain by myself. it doesn’t help that RA is flaring bit by bit each day, and Arcoxia is not helping much.

without considering the 17 years i was undiagnosed, it’s been 10 years. with each day i’m growing more and more weary fighting the pain. and people wonder why i am tired??? i don’t know what i would give to make it all go away. but that would be bliss!

what you don’t know

  1. RA and fibromyalgia changes a person. living with chronic pain does that to you. it makes me embittered and disillusioned with life and the healthcare system.
  2. Chronic pain means that i carry a pouch of medications in my bag always. Painkillers that go up the spectrum in its strength. Topical painkillers. Anti-emetics in case the painkillers make me nauseated. Anxiety also means i carry with me benzodiazepines (usually clonazepam). Without this pouch when i’m out, i’m practically nothing.
  3. RA is an autoimmune disorder, and it can only be managed (put nicely, put in remission), never cured. And there was nothing i did to induce such a chronic and debilitating disease. Mine started when i was merely 1 years old.
  4. Fibromyalgia is a legitimate illness. It is not a diagnosis placed on a person if a doctor can’t figure out what a patient is going through (i.e. garbage diagnosis). No my pain is not psychosomatic. No my pain is not because i’m doing everything wrongly (posture, ergonomics at school/work, the way i sleep etc), No i’m not lazy, i’m just perpetually exhausted/fatigued despite the amount of sleep/naps i get.
  5. I don’t find excuses because of my illnesses. I try my best even through the pain and the exhaustion. Heck it even takes courage to admit that i am giving something up, or if i have to say no, when i feel my disease involvement is really being tested and exacerbated.
  6. i have chronic depression, and it happened (and still persists) not because i was weak. it started in 2010 because i gave too much of a damn about something- something that i was passionate about, and was good at, that pride took over. at that point my eating disorder was in full swing for a year already, and it didn’t help with the stress and pressure i faced.
  7. i fight. and i don’t stop fighting. i fought to finishing nursing school, and fought to finish it well. i fought at and for work as a nurse. i gave up my career as a nurse because undue pressure and sanctions were placed on me just to validate my license. it triggered me everytime i had to go down to board’s office to submit the letter from my psychiatrist.
  8. the people who are in the caring profession are the very people who perpetuate the stigma of mental illnesses. this was something i could never understand.
  9. i’ve lived in hospitals- medical and psychiatric- for a total of nearly 3 years. it takes courage to go in, to admit that i need help. it is not attention-seeking behaviour. and to be honest, all these time in hospitals are the ones that kept me alive.
  10. and yes, as much as it seems the opposite, i am fighting to live. i subjected myself to 63 sessions of electroconvulsive therapy (ECT- in layman terms, electric currents that runs through the head), because i struggle with chronic suicidality. if i seem forgetful, this is why. amnesia is the primary side effect of ECTs.
  11. i’ve been labelled as the “worst case” my psychiatrist has seen, “the most difficult patient” my psychiatrist has had. 70 over sessions with my psychologist yielded almost no effect on my mental health. so pardon me if i think i am a hopeless case.
  12. people have asked it, and implore you not to ask it nor even think about it, why i am “still like that”. do you actually think any sane person (yes i am very much sane) would want any of this bullshit? if i can have it my way, i want nothing of this.
  13. i am always fighting to manage my conditions, and that includes working towards recovery. sometimes i am able to muster the strength to stay relatively well (usually from extrinsic motivations). but it doesn’t mean that i’ve done it before, that it cann be replicated. circumstances are always different. and not reaching recovery doesn’t mean i am weak. it means i’m still fighting. whether it is me managing my symptoms because that seems to be more important at that time, or whether it is me fighting my demons because it feels like i’m well enough to work towards recovery.
  14. i am always seeing doctors, and again this is not attention-seeking. i see a rheumatologist, a pain specialist, a psychiatrist and a psychotherapist (who’s also a psychiatrist), with the occasional visit to a gastroenterologist, a nephrologist, a neurologist etc. i am for the record, not the healthiest person around, and no i did nothing to deserve anything that warrants these visits.

  15. when i cancel on you, it does not mean i’m not keeping my end of my promise. it usually means i’m exhausted through and through, either from the disease process of RA, fibro, or even depression. or it means my mood has plunged, and/or i am crippled with anxiety that i can’t leave the house.
  16. when you see me smiling and laughing, talking (sometimes loudly), walking with normal strides with my head held up, 99% of the time it is a facade you see. this facade is quite true to my old self. and it takes immense energy to keep the facade up.
  17. when you see me turn a little quieter, becoming more reserved and isolated, head down, and walking a little slower, it means the energy that’s keeping up my facade has run out. it means you are seeing a more genuine side of me, and honestly, i’m not fun to be with once this occurs. it can dampen the spirits of everyone, and i don’t mean to do that.
  18. i am easily triggered. when i see images or hear about things like suicide, means to kill oneself (like ropes, pills etc), and all, i immediately withdraw. it can mean that self-harm will come later, but that’s just the way i am. i am extremely sensitive.
  19. when i bare my arms to you, it means i trust you enough not to judge me. i am not proud of my scars. but i don’t want to tie it so much to shame as well.
  20. it’ll be difficult to accept me because of the way i butcher myself. but i always hope people can understand that self-harm is my way of coping, of self-regulating. it’s just like how people turn to alcohol, drugs and ciggs. and if you have questions, i really don’t mind being asked, as long as it is done tastefully.

it’s difficult for people, and even my doctors, to see how pain is inevitably intertwined with depression. everyday is a battle for me. i start off my day downing anti-depressants and a cocktail of pain medications. it’s a judgement call to make, for how much pain medications i need to start my day. a painful day makes for a very moody and/or angsty day. on the other hand, there is no happy pill. when i’m anxious, i pop a clonazepam, but it doesn’t make it go away totally. sadness, despair, distress and worry usually accompany anxiety. and if i can, i lie down, hide under a blanket, an try to sleep it off. if i’m out, i try with all my might to get home to do precisely that- hide and sleep. the worst is when my mind decides that my life is not worth living. there is no anti-suicidality pill. there is only self-injury and ECTs. i don’t hurt myself for the sake of it. ironically i hurt myself to stave off the suicidality (at least when i’m not inpatient), and it does help. it’s difficult to believe it, but it really does help. it helps me to at least live till tomorrow. and sometimes that’s all that is important right?

everyday is still a day of self-discovery, of learning who i am and what i am. everyday is a chance to be stronger, more resilient, more accepting, and a chance to desire living instead of dying.

my friend from my community described me as a fighter, as do many others, in different ways and words. i constantly deny them, because depression tells me everything otherwise. but for the past few days, i’ve thought about it. if i hadn’t fought, even as a child with undiagnosed juvenile RA, would i be here? if i hadn’t fought through the pain even as it progressed into adulthood, and then also fighting with fibro, would i be here? if i hadn’t fought with depression and bulimia, would i even still exist? it answers it all.

lastly, without my faith in God, i am nothing. He was the one who carried me through all these years, giving me the strength and courage when there was none to go on. He carried my crosses (which are my burdens and struggles) with me, and never left me even when i turned the other cheek. what can i say? God is good. God is Love!!!

The Lord will fight for you, and you have only to be still. -Exodus 14:14

being tested

once again, i’m being tested. and this time’s proving to be really difficult.

i’ve lost faith in the mental healthcare system. i should have, a long time ago, actually. times like this, the only advice is to go to the emergency room to likely get admitted. my reluctance to do so most times, is because the team in the ward is literally helpless. they can’t do anything for me. i am there only because it’s a safe environment. but i need more than that and my usual weekly therapy. additionally, the team in the ward doesn’t know much about me. me, and my psychiatric history, is extremely complex. and they haven’t taken the time nor effort to know and understand me. besides, the ward is a terrible place to be. it is not in the least conducive for recovery. so what am i to do?

my psychiatrist can only see me early December at best. and he’s already bending the rules to get that for me. while i am grateful, it’s still a long way to go, and despair is all i’ve got right now. i just saw my therapist yesterday. did my psychiatrist really think therapy would make things better for me? sometimes it doesn’t. sometimes it is triggering. sometimes i stay status quo. rarely i move forward.

i know things are really bad when the tears fall in public. even the realisation that i am crying in public, makes it worse. i don’t like finding myself in this position. yet i feel extremely helpless. i’m at a loss.

my sisters-in-Christ have been trying really hard to support me. they’ve been trying to get me to keep the faith, and rely not on myself, but on God. times like that, this is most difficult. i guess all i can do now is to keep trying. because if i don’t, i’ll be gone from this earth.

More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not disappoint us, because God’s love has been poured into our hearts through the Holy Spirit which has been given to us.

Romans 5:3-5

tough month ahead

it’s been 23 days and my leg is not better. let’s just assume it’s never going away, or that it’ll get worse. tampering my expectations.

i got to see my rheumy today. apologised to her about needing to slot in today because of what the rheumatology team did when i was inpatient. but she cleared some things up and also got a picture of the shit i was and still am going through. firstly, MRI results for my shoulders show bursitis and tendinopathy while on etoricoxib 120mg, but DMARDs still not called for because of its chronicity. however she is still going to be discussing my MRI results with the radiologists. secondly, it’s very rare but RA can involve the nerves in the way it did for mine (other than peripheral neuropathy) but it would show up on the nerve conduction studies (which nothing did). thirdly, we don’t know what that odd thing my leg does  when i try to flex it with my foot pointed when i’m lying face down. she has to ask someone else about that too. she’s showed more compassion today, which was helpful because i’m not in the best of my moods today and i was entirely sleepless last night.

hours prior, i saw my psychiatrist. he upped my lithium. it only can mean one thing. doing poorly. it has been some rough 2 or 3 weeks. so the order has been given, he has been pre-empted that the hand tremors will worsen like it always did when we tried it, but there is a chance it’ll help me as it has in the past. how else?

another research methods module to frazzle me further this month. it’s gonna be a tough August, Steph.

 

what’s up

  1. hit rock bottom (in maladaptive coping methods). emailed shrink. he said i should be admitted inpatient to keep me safe.
  2. did not go to the psychiatric hospital directly.
  3. went savage on the body. bleeding couldn’t be stopped after 2 hours. wound up in the Emergency and waited 11 hours for a bed.
  4. surgery to fix the damage i’d done. lungs didn’t take in as much air as they’d hope post-surgery. spent hours with nasal prongs.
  5. medical hospital’s psychiatrists decreed to send me to the psychiatric hospital (oh when do they not?), so i was shipped off.
  6. admitted in the looney bin involuntarily.
  7. struggled in the ward (it’s a madhouse in there), but got out in 4.5 days.
  8. was so happy to be out i shopped, dined and drank.
  9. then guess what?
  10. i screwed up again.

i don’t know why it happened. i mean, it’s fine by me if i screw up but am able to fix it myself. but no. it went awry. i could never fathom the consequences that resulted from my actions. let’s just say that with one decision (and action) i made, i spent at least 5 hours trying to stop it from making my room look like bloodshed, and i from fainting.  5 hours and i am still feeling unwell, my room a warzone. but at least the toilet is fairly ok.

i’m seeing my psychiatrist in a few hours. i think it is not unwise to say that i will be put back in to suffer again. although there is a chance i might get away scot-free, really.

i am such a disaster.

let go, let God

sometimes i don’t know if it’s letting go, or giving up. it’s a fine line.

for many years, i’ve fought against everything that ailed me. it was mostly pain, then it was the sinking sadness, the murderous suicidality, the ravaging hunger, everything. i didn’t want them. i want so much to make them go away. i wanted real solutions. but everything i have fought for gave me only temporary reprieve. they were still there, and it only made me angry. mostly angry at myself, but also angry at the doctors. why couldn’t i get better? why couldn’t they fix me? i never had the answers, and they didn’t give it to me as well. for years i left consultation rooms both angry and disappointed. the anger raged within me and it fed into the monsters in my head. the hopelessness and helplessness only served to dump me down. it didn’t make things any better.

i must’ve have gone through this phase several times in these last 10 years. my mind shuts down. i stop fighting. i give in. i let it all eat me up. it means that i am settling. i settle with the pain and i will stop asking my doctors to fix me (both my anaesthetist and rheumy). i settle with what i have right now with pain and disease management. i settle with knowing that i will not have answers nor solutions. does it help with the pain? no it doesn’t. but the anger within me quelled. it was like *phew*. the load on my shoulders got significantly lighter. i can breathe better. letting go after trying so hard to gain control over every aspect of my life, was a world of a difference.


i talked to my anaesthetist. i told him that right now i could settle with plain Anarex (paracetamol+orphenadrine), tramadol, and Arcoxia (etoricoxib). that i didn’t need any Oxycontin because i am ok where i am right now. he was cool with it, after some hoohah over opiates between the medical and psychiatric hospitals. he understands that if i do need it, i will reach out to him. but right now, i don’t wanna be popping unnecessary pain meds that will not help with chronic rotator cuff tendinitis.

i talked to my rheumy today. she was very concerned by the possibility of me having MS, and went on a tendon-tapping frenzy today. but besides that, we have established that i am now RA quiescent- i’m in remission. nevermind the rotator cuff tendinitis that’s long-standing now. i told her also that i will settle. it’s a compromise. i don’t want to medicate myself further just to eradicate the tendinitis, because it’ll probably be futile.

(i’ve never really connected with the clinic staff even though i’ve been seeing my rheumy for 8-9 years. but today, an assistant nurse tells me that she knows i’ve been around for a long time. i didn’t think anyone would notice, but well, they did. made me smile!)

i am, to be honest, extremely heartened that these 2 doctors are playing very much of a supportive role. they ask my opinions on what they can do for me, or on what they can give me to help me. it took awhile for us to reach this point, but i don’t blame them. it’s difficult to see for themselves a patient who butchers herself in unimaginable ways, who is plagued with medical and psychiatric admissions, and has so many things on her plate that everything health-wise is intertwined. both of them are parents themselves, and i witnessed their difficulty accepting a patient like me. parents’ instincts i guess. their letting go, and now me letting go, has made it supremely easy to cope.


i’m not quite sure though, if i could settle with the psychic pain. the anguish and the torment of living with depression, self-harm, bulimia and borderline traits, is like free-falling through an infinite drop. you think the horror of falling is ending, like somehow there’s ground somewhere. but it doesn’t end. it will not end until i’ve suffered enough. i’ve let go in a way that i’ve tried to not grasp everything in my head- that’s cruel to myself. i’ve let go in a way that i don’t fight aggressively with my monsters. i’ve settled on knowing that my psychiatrist will not have answers for me- none of them ever had, so what makes my current one different? they know that i am notoriously difficult to treat, my severe depression refractory. i accept that they can’t quite save me. i accept that they are treating me symptomatically and keeping me functional. damage control. we were, and are never in that stage where we look forward and say that “hey let’s work towards recovery”, because i’m not there yet. i’ve never been. everytime i get closer to that, i fall. and so we’ve learnt.


it takes courage and faith, to let go of what i cannot control in my “sufferings”. i’d like to think that i am not giving up. rather, i place myself in the hands of God. i accept how things are. and i work with what i have. i will not chase for answers or solutions if there’s likely none. i will not fight, not because i am weak. but because fighting is counterintuitive. i will cope with these “sufferings” with faith, hope and time. and perhaps one day i’ll be able to say that i’ve triumphed over these “sufferings”. i have doubts with what i am doing right now (everything i’ve mentioned in this post). but this is the only way to go, where i am. and i’ll place it all at the foot of the cross, and give it up to Him.