Medical records

I’m angry.  I’ve tried to be patient.  Now, i’m pissed off.

My last inpatient stay was in Feb. 2013.  On 7/10/13 I called the hospital and requested a copy of my records.  According to the hospital, since I’ve requested the entire record, they had to send the request “upstairs to be approved.”  OK.  Once approved, they would send an authorization form for me to sign. 

On 9/10/13, with no word or form from them, I called the hospital again.  They told me that I should have gotten the auth. form by now, but, no matter, they would send the form out that day.  True to their word, the form arrived and on 9/14/13 I mailed it back.

So, today, I called the hospital and was told that they had sent the record to an independent company for copying and they gave me the order number.  When I called the copying company I was told that the hospital only sent them “an abstract”, not the entire record as clearly requested.  Now, the request has to go back to the hospital for approval (again) for the ENTIRE record.

I have a bad feeling.  I’m worried they aren’t going to release my records to me.   I may be wrong.  All the other times I’ve been inpatient (elsewhere, however) I’ve been able to get the majority of my medical record sent to me. They have occasionally omitted certain documents like a forensic evaluation or the proceedings from a commitment hearing.  OK, I can live with that.

I’m a medical person by history and by nature.  I want to read the records.  There are often some insights to be gained from looking back to a bad time in my life.  It helps me to try and make sense of confusing times. 

I’m particularly interested in my records because I usually have more ECT during each hospitalization and my memory loss makes it hard to remember exactly what happened.  This past time, I have no idea what happened for the first 3 weeks and can only recall “waking up” in the 4th week.  I don’t even remember giving consent for further ECT.  I don’t know what meds. were given or therapies I may or may not have attended.  I was on 1:1 obs. up to the minute I left the building and I have no idea why.  I don’t know what was given as my diagnosis or co-morbidities – probably the same old thing – but I want to know.

Why wouldn’t they release my record to me?  Is there a valid reason not to do so?  If I had ANY other medical illness would they even hesitate to release it?  I don’t think so.  If they decide to withhold my records i’m afraid i’ll have a meltdown or blow up over it.  Not pretty or maybe even an “appropriate” reaction, but I can feel it coming on.

So, right now, I’m mad.  I want the records and I want them now.  I’m tired of being patient.  It gives me a headache.

Doc.

    

Backache

This morning I seemed to have thrown my back out – making the fucking bed. Intense, mid-lumbar back spasms. Great.

Also – and tell me if this has ever happened to you – somehow, walking along, between one stride and the next it felt like all the bones in my left foot had broken. Every attempt to bear weight on my foot was rewarded with agonizing agony.

I was limping and hunched over with someone stabbing me in the back.

So, I grunted my way into the bathroom and grabbed 2 Advil, then made progress towards
the ‘fridge where I found and downed 2 shots of W.Va. moonshine.

I feel much better now. Doc.

Care givers

This week I asked my therapist – D _ if he thought people with mental health issues were good at seeing mental illness in others, especially their own illness/diagnosis. Also if people with issues make good MH professionals.
He thought about it for a full minute then said “I think they can be good therapists etc. In fact a good many in MH come with a background of mental illness. (I’d heard this was true.) “The problem arises when someone uses anothers’ therapy to work on their own issues.”
Me: Hmmm… Nod. He didn’t really say if he thinks we’re better a detecting it, though.
D: “In fact, I remember when 9/11 happened. I was at work on a psych unit when we heard the news. Since we were only a hour from NYC the entire hospital was put on lockdown. No one could leave as we might get patients. People (staff) started panicing, wanting to get home and check on loved ones. In the end, it was the patients who comforted the staff and tried to help them cope.”
I thought this was sweet. It touched my heart.
Doc.

Edit: I wrote 3 posts today and baked shortcake for strawberry shortcake while listening to The Black Crowes on my MP3 player. Can anyone say hypomania?

Delete

I checked my email acct. today and I have 1147 things in my inbox. 1147! Fuck me. How has the world not blown up when I have that many things I should have been dealing with?
Same thing with Facebook requests and friend notifications. Who the fuck are these people? Why should I care?
Sometime ago I decided to DVR some classic Bugs Bunny/Looney tunes cartoons. I like kid cartoons especially when i’m depressed or high on pot. So, now, I have over 200 episodes recorded. When do I think i’ll EVER have the time to watch them all? I think part of the reason I recorded so many of them is because the newer ones = anything after 1962 – SUCK. I need classic cartoons if I am to survive.
So, I decided to be responsible and practical plus the fucking DVR keeps reminding me I only have 1% of space left. So, yeah, I started to prune my library of cartoons. I’ll be happy, ecstatic if I can get back to say 50% space left. But it’s a fucking boring exercise of select, arrow over to delete, hit delete, repeat.
The Yahoo acct. is going to take forever to clear out. Mostly because I might have to actually read a few of them. Hell, I know it’s 4 months old. but it might be IMPORTANT.
Facebook, just fuck off. I don’t need this shit.
Don’t even try to tell me about Twitter or Tumblr or anything else. I’m doing the best I can. Fuck you.
Doc.

Behavior

I decided to drink a little wine today.  For the past 6 months or more I’ve lost my taste for it.   I used to drink a couple of glasses each week, sometimes going way overboard to utter drunkiness and general dishibition and silliness.  (I’m a happy drunk).  To be honest, I was hoping for more with todays’ drinking. 

I’ve been reading more about bipolar disorder and possible triggers for hypomania.  From what I’ve read from some sufferers, alcohol can  sometimes be a trigger.  Unfortunately, my drinking today did not lead me into the promised land of hypomania. 😦  If that sounds odd, too bad.  I’ve only recently had or recognized an episode of hypomania and I like it.  (It’s only rock and roll, but I LIKE it.)  I liked the mental sharpness, the sudden flow of good ideas, and the productivity.  Instead of walking past the overflowing laundry basket and moaning “I really should wash those clothes” it’s “yea, I can do some laundry.  Great”.

Caffeine, another reported trigger does nothing for me.  Sleeplessness, on the other hand, shows promise.  But i’m not sure if being awake leads to hypomania or it’s the other way around.  

For the duration of my illness, about 4 years now, I have been depressed.  Lots of different meds., lots of “therapeutic interventions”, and years of talk therapy.  Nada.  So, now I am drug free (I don’t count the pot).  I’m not symptom free, but i’m not worse.  In fact, maybe i’m finally going to see how my illness truly manifests itself. 

I read recently about a woman my age who used cocaine to treat her bipolar depression.  I used coke a little in my twenties and while I enjoyed it, eventually I left it behind and got serious with my life.   I told my therapist this week that I kinda long for the way coke made me feel back then.  I want to feel that way again .  (Concentrated scribbling in my chart by him.)  But I told him  I do recognize that it is quite expensive and sometimes it’s hard to stop. I know it’s not the “real” thing, but a break from this would be welcomed.  For now, this option is on hold.  I’ll be good.   

 Anyway, the reason for this post is to relate my experience at a recent veterinary continuing education meeting.  The speaker was a board certified veterinarian of small animal (dogs and cats) behavior.   Dr. S. spoke about psychoactve medication (sound familiar?) and behavioral modification techniques.  One of her main points was that we often need to medicate our patients first so that they can then engage in and learn from behavioral modification ie:  therapy.  Anyone who has had the pleasure of seeing a psychiatrist these days will recognize the mantra of “medications are only one tool in recovery”. 

As the lecture progressed she discussed all the familiar meds :  SSRI’s – Prozac, Paxil, Zoloft, SARI’s – Trazodone,  alpha-2 adrenergic agonists – Clonidine, antipsychotics/neuroleptics – Thorazine, Mellaril, Haldol, acepromazine, narcotic antagonists – Naltrexone, TCA’s – Imipramine, Elavil, clomipramine, azapirones – Buspar, GABA analogues – gabapentin, benzos – Valium, Xanax and clonazepam, and MAOI’s – selegline.

 

 

  

     

She also discussed nutraceuticals, herbs, antioxidants, dietary therapy, melatonin, pheromones, acupuncture/pressure, and aromatherapy. She provided worksheets of tested and proven protocols for various problems. She covered a lot of bases.
Interestingly, dogs and cats suffer with many of the same mental/behavioral problems that we do. Anxieties, phobias, panic disorders including panic attacks, compulsive disorders, aggression issues, cognitive dysfunction, self-injurious and stereotypic behaviors like circling, pacing, barking, and tail chasing (not the same thing here!)
Apparently, antipsychotics are not used for psychosis in animals. I have to question the assumption that dogs and cats do not suffer from psychosis. I mean, how would you know for sure that they aren’t hallucinating or delusional? I’ve known quite a few animals that were reacting to something that either wasn’t there or I couldn’t hear/see it. How do you ask them? “Say, Buster, do you see a cow in the living room right now?” “Do you hear bluegrass music coming from the wood stove?” “Do you think animal control officers are watching you?”
She also made the comment that animals don’t get depressed. Bullshit. I’ve met plenty of them who display the classic symptoms of depression – loss of appetite, excessive sleeping, amotivation. Usually situational like the death or absence of a loved one.
Bipolar disorder and schizophrenia spectrum disorders? Again, hard to tell. But I do have some breeds I have my doubts about.
One area that was mentioned but seems to have less occurrence in animals is medication side effects. Side effects in small animals include – dry mouth, constipation, increased appetite and weight gain, ataxia, cognitive impairment, GI upset, sedation, tardive dyskinesia, and restlessness. Many of my significant side effects included unwanted and unpleasant thoughts and beliefs. How do we assess this in our companion animals? How do they tell us about these? I don’t know, but I worry about it.
Doc.