Crying

I feel like crying.

My therapist D rescheduled our usual Friday appt. to Thursday evening (he had a surgery appt. himself on Friday). He asked me how my week had been and I croaked out “BAD”. (More on why later.) He told me that he had been in communication with the director of the mood disorder unit I had been on last year in February. He had been honest and told him I was interested in another course of ECT and that I was not on any psychotrophic meds(and I don’t want to be) and I was using cannabis daily. Well, Dr A. wrote back and told D he would not accept me as a patient because: 1. I’m not on any meds., 2. I use pot daily, and 3. it’s only been 12 months since my last ECT treatments. I really couldn’t believe it, I sat and tried to think about it, but my mind scattered and I felt myself floating away. A few minutes passed in mutual silence and D asked me “What are you thinking?”

“I’m done.”
D- “You’re done?”
*Nods* “I wanted my family to believe that I’ve tried everything to get better.” And I do. Granted, I was hoping I could feel better, even a tiny bit. I also wanted to experience how just ECT alone would make me feel as I desperately need to feel better and I think it is my decision whether or not to take medication. When I could think linearly again, I started to analyze Dr A.’s statement. As I recall, last Feb. when they admitted me to Dr.A.’s service/unit it had been 7 months since my last ECT(at another hospital), I was smoking pot daily, which they knew, and I was not on any meds. So, WTF? Was I a bad patient last time? Was I a difficult patient, did I do something wrong? I don’t know, I don’t remember most of Feb. 2013.

Ah… meds. Last time, I dutifully took any pill they thrust in my direction, without argument. That’s it, isn’t it? As long as we “agree” to be medicated into senseless twats they feel safer and in control.

Now. I usually try to see different opinions and perspectives. I tried to imagine what I would say to a client who came to me and asked me to treat their pet in a manner that I – 1. didn’t approve of or 2. didn’t think would be successful. Honestly, I do believe that clinicians should be able to refuse to be involved in someones’ care if that clinician believed it was going to be a clusterfuck.

That said, where does patient choice and self determination come into this?

Also, ****Hospital is a university-based, teaching hospital. I had hoped they would be more willing to go off the grid and try something different. Could I not serve, in some way, as an example of patients these newly minted psychiatrists are likely to encounter in their futures? Surely, not everyone will want to use medication. Does the practice of psychiatry fail at it’s core without medicated sufferers? Do they have nothing else to offer?

D asked me if I would agree to see a new shrink (last saw mine in May 2013 and D has made little attempt to hide the fact that he doesn’t like my old shrink.)

*Shakes head slowly no* Shrinks mean meds. Then he asked me why I don’t want to be medicated, had I done any research on psych. meds. (really, D?) I explained all this again.

So, for now, he has asked for my permission to contact Dr.A. and see if I can get into any research project currently ongoing. I suspect that I may have to reconsider my no meds. stance in order to access a higher level of care +/- ECT. Frankly, I’m becoming more ambivalent about further care by the day.

I, too, heard the sad news of the death of My Crazy Bipolar Life this week. Also Amy of iamfightingawarminejusthappenstobewithlife – has lost her life. Suicide, I presume but I don’t know. I didn’t know Amy as well as MCBL but I’ve been reading both of their blogs. I lost a close friend to suicide when I was in my twenties, but this is the first time someone I have never met but knew only through the internet has died. I am very sad. I know many people are too.

I am crying.

Doc.

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Waiting

I’m bored. And ambivalent, anxious, confused, and somewhat self destructive. I’ve been waiting to hear from my therapist D whether or not ****Hospital will accept me for ECT with the proviso that no unwanted drugs will be used against(on) me.

I just took a break and had a cigarette, a banana, and a bong hit. Last of the Summer Wine is on the TV.

So, last week D told me he had been ill and had been having tests and treatments(enemas) to help relieve his intestinal obstruction. TMI from a therapist? I started asking him a bunch of medical questions because I’m nosey and that’s what I do. Any new foods, any new meds., any family history of specific GI diseases, my advice(unsolicited) on which laxative to use next. Interestingly, he answered my questions. Then told me I was “different” when I talked about medicine. I know, my old life.

On Thursday evening D texted me that he would have to cancel our Friday session as he was having an emergency colonoscopy. FUCK. I had already worked myself into a state during the week which resulted in me needing to turn off my fucking head and taking a mini-overdose of Trazodone to make it happen. Slept for 16 hours.

I did ask him Thursday if there had been any decision re: ECT. “Still working on it.”

This week I’m having doubts about whether to have more ECT or not. It’s probably not going to change anything. Just make me dumber. I feel like I’ve been not me for so long that I should finally accept it and go with Wolf. Part of my reasoning to try it one more time is that I want my family to believe that I tried everything to get better.

At this point I’m not sure what to do. I’m waiting to see if D has to cancel this Friday.

Doc.

Dentistry and drug abuse

I was lucky. As a child growing up in the sixties, I had the good fortune to have parents that insisted on routine dental care. I remember having checkups and cleanings and cavities filled. The cool thing was, I was never afraid to go to see him. In fact, I looked forward to our visits. His name was Dr. D. (I once had a dermatologist named Dr. Spot.)

The reason I liked going to see him was because he always used nitrous oxide on me. I can still remember the way the mask felt over my nose and the way the plastic smelled. The gas itself had a smell, but I can’t remember now what it was.

Anyway, he was my first drug dealer AND it was all legal. I can remember the feeling of drifting away and the sounds in the dental office fading from my awareness. I loved that “high” feeling and was usually disappointed when we were done.

When I had grown into a teenager I sought to re-experience those early buzzed times and turned to pot as my next drug of choice. Very similar body and cerebral effects, those two substances. Over the next 10 years or so I tried other substances, mostly acid, cocaine, and alcohol. But, my real love has always been pot. Researchers and others refer to pot as a gateway drug to “harder drugs”, but my gateway drug seems to have been nitrous and it was introduced to me as a legitimate and acceptable treatment component.

Over the years, my natural clumsiness and bad luck have made narcotics available for me to sample and enjoy. I know a fair number of people whose drug use started or was triggered by appropriately prescribed pain relievers. Luckily for me, I was never deeply seduced by non-cannabis options.

The reason I wrote about this today is that last night after my usual bowl of Coco Puffs with whipped cream on top, I inhaled the remaining nitrous oxide from the whipped cream can and the short-lived but very intense buzz that followed reminded me of my visits to Dr. D. I’d love to have my own tank of nitrous, but I’d probably over do it and die without someone to monitor me and take it away when I’d had too much.

Doc.

Options and conditions

I went to therapy this morning. D started-“You said at the end of our last session that you’re considering ECT again. Still feel that way?”

“Yes. But I will only do ECT, no meds. I want to know what just ECT does for me, without 2 or 3 new meds. fucking with my head. I’d also like to do it outpatient but I don’t think I have a ride. Do you think they will let a cab pick you up after? I could drive to a block away, take a cab there, cab from there to my truck, and I could drive myself home.”

D-“No. That would not be safe. So, maybe inpatient is the way to go. Do you have a feel for where you’d like to go?”

“Well, I can’t go back to ******Hospital because the shrink there doesn’t take any form of insurance. I still owe her about $3,000. Probably ++++Hospital would be OK.”

If I go inpatient will/can:
-I be admitted directly to the floor and avoid the ER? D – “no, not likely.”
-they promise not to transfer me somewhere else? Specifically “Shithole Hospital”(you know who you are.) D – “No, they won’t do that.”
-they promise not to force me to take anything I don’t want? D – “I will call and see if I can negotiate this with them.” This may prove to be a sticking point.
-I smoke? D – “No.”
“I know there are nicotine patches. Are there THC patches yet? or caffeine patches?” D -“No.”, smiling.

So, I don’t know what is about to happen. Except that I’ve got to go put some wood in the woodstove. It’s freaking cold here today.

Doc.

ECT again?

I want to write this down before I get stoned for the first time today.

I’ve been considering another course of ECT. I can’t, in all honesty, say that any of my previous treatment courses have made me feel that much better. In the past when I’ve had ECT I’ve also had a change of meds, so I could never really tell what was making me feel different.

This time, if I do agree to try it again, I will ONLY accept ECT, not any psychotropic medications. OK, if I have to, I would take something for sleep or acute anxiety but no antidepressants, mood stabilizers, or anti-psychotics. I wonder if any ECT program will take me if I refuse their other treatments (meds)?

I also would greatly prefer getting ECT on an outpatient basis. The main problems are that my sister cannot take the necessary time off from work three days a week to drive me to and from the hospital and they won’t let you drive yourself.

The problem with going in as an inpatient is that historically my self harming behavior gets much worse and then I get stuck on a 1:1. I also hate not being able to remember what happens in the weeks surrounding ECT treatments. I spent 4 weeks in the hospital last time and I can only remember the last 7 or 8 days of my stay. I’d rather be confused and forgetful at home.

The other big problem about inpatient care is I can’t smoke cigarettes or pot in the hospital. Huge deal for me. I know that my nicotine, caffeine, and THC dependencies are not especially “healthy coping mechanisms”, but they are mine and they are the only reasons I’m still alive today. Let’s not forget lack of privacy, too many other people, strange food, and somebody else’s schedule.

I will talk to D about this tomorrow.

Doc