semicolon: 8. Wednesday

Awakened early from a poor sleep and was told breakfast was ready.  Getting dressed meant putting on my personal socks and the grippy socks over them.. I was chilly and didn’t mind the layers.  It also would hopefully help the fact that a middle aged guy was walking on hard floors without the usual orthopedic inserts in his shoes.  Used the bathroom and headed down toward the nurses station.  When I got there I got the usual “who are you?” and they took my vitals.  I didn’t have my sweater or a sweatshirt, and they offered one because I looked so cold.  The truth of the matter is that I was so anxious I was shivering and shaking.  Also likely looked like a deer in headlights, the new guy in prison.

My blood pressure was quite high, but not enough to be worried about.  It was, after all, probably the most stressful morning I’ve ever had.  That includes Marine Corps boot camp.  I learned early on that this was comparable to boot camp.  If you understood and played the game, nobody would mess with you and you wouldn’t get a minder.  Although this experience had much less panicked running around.  One of the standard items I had been given was a notebook, and they showed me where I could get a safety pen.  Just like boot camp, I wanted to remember as much of this as I could, so I journaled as well as I could.  The shaking didn’t help, but none of my notes were indecipherable when I came back to them.  It was so nice to be writing, getting thoughts out.  I’m an introvert who is comforted by telling stories or making detailed observations.  It also seemed like a pacifier to help with my social media, texting, and email withdrawal.  Though that wasn’t much of a problem.

I was one of the last to have breakfast, but they placed me with Old Man, and that felt a little comforting.  He excused calm.  Because I hadn’t had an opportunity the night before to fill out a menu, I got what I would call a generic breakfast.  I was beyond being able to eat, so I drank the milk and juice, and the coffee.  I prayed it was decaf.  I didn’t need a caffeine buzz today.  I was not likely to be gaining weight this week.  One of the meds I was on was an appetite suppressant, and I had been losing weight quite nicely, without exercise.  Might not be a healthy loss but I’ll take it.  And after I’m out and strong enough, I intend to bring back my usual 3-6 mile walk every day.  As it happened, that was foolish optimism.

After breakfast we had the unit meeting.  It consisted of a quick check-in, might even have been just a word to describe how you were feeling,  Also your name since turnover was so high, and we were presented with the topics for today’s groups.  I skipped the early one, so I had a couple hours to fill the time, which seemed daunting given the level of anxiety I was experiencing.  At the end of check in, Singer sang Amazing Grace acapella.  It got stuck in my head and I told her so later that morning, thanking her for getting it stuck in my head.  She was one of the first patients I talked to.  I had until 11:15 for my first group, and no clock in my room, so I kept having to walk down to the nurses station to check the time.  I hadn’t come up with the white noise machine timers yet.

Around ten in the morning I was visited by a medical resident and a student to prepare for talking to the MD later that day.  I told my story again, and I am really good at it by this point.  The resident responded with “Wow.  You’ve been through a lot.”  Summary:  Major depressive disorder, generalized anxiety disorder, treatment resistant depression, therapies include multiple PHP, day programs, a full round of ECT, a full round of TMS, groups focusing on CBT or DBT and occupational therapy.  Had memory and cognition issues from the ECT.  Also multiple psychologists through the years as well as multiple psychiatrists.  Many different drugs, some given up and some still layered on my typical regimen.  A suicide attempt after years of passive and active suicidal ideation.  Childhood trauma in the form of neglect, losing my job, which was really ending my career, and having two kids in college.  So I was now an empty nester with Wife.  So yeah, I guess I have been through a lot.  I considered myself a professional depressive at that point.  The resident said I would for sure have a CPAP that night, likely a hospital provided one, but Wife could bring my personalized one from home.  Mentioned the minder overnight thing, which I will explain later.  I ended up hopeful that I wouldn’t be here forever.  Which was a big deal for me.

Around 11 I talked to my case manager.  I didn’t think I really needed one, but whatever.  It was really just an introduction and a little bit about logistics.  Her primary role would be helping me with post-release programs and appointments.  She ended up being very thorough and ahead of me by a couple steps most of the time.  I would ask her about something in general and she would already have my back history explaining why I was asking, but always had a plan and had already begun the effort, like setting up a PHP after release.  She had my sister’s name, so she was one of the few people whose names I would remember.

At eleven thirty I had my first group.  It was an OT that consisted of a dice game.  You would roll two dice and look up that combination on a sheet.  And then you answered the corresponding question.  They were things like “My triggers are..” and “When I’m feeling anxious, the best distress tolerance that works for me is..” and “my earliest memory is..”  On the back side of the sheet were more softball questions, like “My favorite food is..” or “My favorite season is..”  It was fun, and I forgot myself a few times, which was a relief.  I also got to know some of the other patients much better, and they got to know me.

Lunch was okay, but I don’t remember what it was.  I do remember it was still too much food.  I sat with Steve-O and Mumbles. Had a good conversation with Steve-O and got to hear more clearly some of the things mumbles was saying.  Some were statements about himself and how he was feeling, repeated and evolving as he said them.  My full body shake was much quieter, but I was still running at an extremely high stress level.  I felt I had to put on my Human Face during the group, and that’s always exhausting.  It also makes me feel like maybe I shouldn’t be there, but I noticed everyone else does it sometimes, and I should just enjoy the moments where D and A aren’t pestering me.

At some point in the day Singer turned and said something sharply to a place where there were no people.  I think she has hallucinations.  Wasn’t actually creepy or anything, just fascinating.  Most of the patients were fascinating in many ways.  Their experiences, their problems, their attitudes all made me feel more connected to them with my own situation.

Talked to my assigned nurse, answered some questionnaires, filled out some forms, and was finally able to see about getting things from my locker.  She gave me my book “The Social History of {my instrument}, Volume 1.”  Thick and boring to most, but not me.  She also gave me the clothes I brought with me in my backpack, except the pajama pants.  And finally she let me have my slippers and sneakers, which didn’t have shoelaces.  I immediately put my shoes on, they felt so much better than none.  I also put on my sweater right away, and that made me feel more comfortable and myself.  Asked the nurse my list of questions, mostly logistical and about rules.  As soon as we were done I went to my room and changed into jeans, a t-shirt and my sweater.

I finally got to speak with the unit psychiatrist, and she was very nice.  She really seemed to understand what was happening to me. This was the day to get to know me, and her questions were quite on point.  She essentially boiled it down to minimize my drug load, maybe tweak them.  Also, we would need to address the grief of my career, children not being home, etc.  Finally, something about my identity and needing to figure out who I am again.  One thing bothered me.  I have always wanted my depression and anxiety to be special or unique.  And if it’s not, I think they can’t understand what I’m going through.  This MD had seen so many different cases and patients, It was hard to appear as some new and interesting case.  She did mention the “You’ve been through a lot!” quote and that was nice.  To finally be recognized for all that I have experienced, and how hard it was.

I was also starting to question my usual psychiatrist and the hospital she worked at.  It was where my kids were born, my ECT, TMS, PHP and day programs had been.  It was our home hospital.  But I was concerned that here was a doctor who had identified some specific issues and talked about meds like she knew what to do.  My normal psychiatrist hadn’t come up with some of those things, and she knows about me as well as anyone could.  I eventually dropped that thought when I considered the fact that this MD was actually a professor and specialized in stabilization at the inpatient units.

I was assured that I would see the MD every weekday that I’m in the unit.  She got me thinking, though.

I was thinking about depression and anxiety being my primary relationships.  Could it be because everything I used to identify myself is gone?  So if I work on my identity, that will help.  That also sent me down a path to reflect on who I really was.  So I wrote down all of the things that used to identify me, and everything else, plus new interpretations of the deficits.  So who am I?

  • booksmart clever
  • funny
  • great memory Able to let go of missing thoughts
  • accomplished accomplished in my past, likely will be again
  • programmer/technologist speaker and writer, a creator
  • husband
  • father
  • brother
  • son Love and loved by wife’s family
  • a bit overweight thinner and healthier
  • wiser?
  • stable working on it

I also had a hard time understanding how I was feeling.  Overwhelmed, for sure.  But I’ve had so many strong emotions, mostly bad, so it’s hard to remember what normal is.  Is depression as an 8 out of 10 normal for me now?  So what does worse feel like?  I kinda don’t know how I feel anymore.  So I guess I have to once again figure out what feels.  At the time I wrote the things I was experiencing right then:  tired, stressed, in problem solving mode, anxious, depressed, and hopeless.  And the hopelessness feeds on the effort and self discipline that future work will require.

The staff member who does CPAP equipment check-outs came, fit me for a mask, and the pressure seemed a bit stronger than usual, but I like it like that.  Again I was confronted by the thought that maybe it’ll cause an aneurism or something and I’ll die in my sleep.  I longingly hoped for that scenario.

Was about to anonymously describe the other patients on the unit but remembered Girl, interrupted and how that blew up in her face.I did eventually take very cryptic notes about some of my co-patients, and then expanded that when I got home.  You can read those in the “Inpatient / People” section.

The afternoon group was OT, creative arts.  I made a sticker by number of a woodpecker.  It was simple and maybe childish but it did help me get my mind off myself for a brief time.  I was interrupted by a call from the pharmacy confirming my meds.  Which is always a hassle given the total number of meds, and the fact that of the eleven pills I take, some of them are of different doses, so you have to walk people through the med list and explain how things work.  I am surely getting better at that.

Dinner was mixed.  It was chicken tenders and plain white rice.  And peaches, which I hadn’t ordered but ate anyway.  The chicken tenders were really good, but the rice was bland.  Ate everything though, which was good for me.  Socialized a bit at dinner and I’d been slowly getting to know some of the other patients in a friend-like way.

I called Wife, and she was very relieved I was getting the help I needed.  Her demeanor was much more calm and level.  She said she would come visit me Thursday night and every night after that.  I thought “why bother?  But, ok..” which is indicative of the isolation I felt most of the time.  I looked forward to her visit immediately, and that helped me get through the horrible and brilliant next day.  She and my aunt were going to tag team on the weekends, as there were two visiting times.

At some point during the day I folded and organized my clothes on the shelves.  It made me feel a tiny bit like this was my space.  Wall locker ready for inspection!  I still hadn’t showered and knew I was going to have to sooner or later.  I was still wondering when I would get out of the hospital, vertically or horizontally, I didn’t care which.  I was hoping I’d be out by the end of next week, but didn’t want to get my hopes up.

Our evening group was art therapy.  We were given two outlines of a profile and were supposed to color one that showed how we felt when we were anxious, and one that showed how we felt when we weren’t anxious or depressed at all.  I let my creative juices guide me and ended up with one that looked like chaos, and another that looked like the profile was blue skies with clouds, and outside the profile was sunlight and warmth.  I liked how they turned out, and when we had to go around to show and explain our completed work, people seemed impressed.  Showed a couple people after group and they were impressed as well.  So not only did I get some feelings out, but I got the boost that comes with recognition of a job well done.

I had used colored artists’ chalk for the two drawings, and spent quite a bit of time afterward thinking about what I could do next.  It’s not therapy if there isn’t some art and/or coloring!

When I explained my drawings, they were pretty straightforward.  After my explanation and the response from the occupational therapist, I said out loud the line about “it’s not therapy without art.”  I then mentioned that when I was in my first day program we made a ton of art and I would bring it home and my wife would just stash it away.  I had been going through ECT at the time, and it erased much of those memories and had made it hard to think since.  After my ECT and day program had finished she started putting one of those creations on our refrigerator door every week or so.  I would see it and be amazed, as I thought it was really good, and that it somehow captured how I felt at times.  I asked who the artist was and she said it was me.  So that was a fun little perk after the program.  When I finished telling the story and looked up, all I could see were shocked faces and wide eyes.  Some of these kids might be more messed up than me, but I had time and experience on my side.  At some point, I had to explain what ECT was to a few friends who had asked what it was..

I went to my room near lights out, and the CPAP was brought to me.  Every moment I was in the room with the CPAP machine, I had to have a round the clock minder.  Just so I wouldn’t use the cord for shock or as a ligature, etc.  It did seem to me that it had a number of good uses for suicide.  Except for the minder sitting in a chair in my doorway.

I started the machine and had a loud air leak, and the mask had a tiny leak that sounded like a whistle.  Not awesome.  I managed to stop the big air leak by tying a sock around that part, but it meant that I had to be very careful when I moved.  The whistling persisted no matter how much I adjusted the mask.  I’ve had a number of different masks and sizes, but it just wouldn’t seal.

Unfortunately everyone who took a shift as my minder seemed to have a cough.  Every time I came close to falling asleep, a loud cough would whack me awake.  Also, since my neighbor needed 2 full time minders, they were always chatting – and sometimes my minder would join the conversation.  Still not awesome.

Midnight brought some commotion on the unit.  Tank was yelling and I could tell it was both in and out of his room at times.  Since I had a minder, my door was open and I could hear everything quite well.  He was yelling something about taking him to the emergency room, over and over.  Not sure what was wrong with him.  Eventually I heard the thump I was expecting, and the yelling turned into “I’m not resisting!” although for a while it was “stop resisting!” so he was a bit confused.  And we all know that saying you’re blurry resisting often means you are, and always means you’ve lost the battle.  Eventually he stopped yelling.  I don’t know if they sedated him or talked him down.  But it finally got quiet.  

And yet I still didn’t sleep.  Eventually I was totally over the coughing, whistling, and leaking.  So I took the mask off and my minder came in.  I told him to take the CPAP and asked what time it was.  Three thirty.  So I could still get four hours of sleep without someone staring at me and coughing, the door closed and no extra noises beyond the white noise machine.

Nope.  Brain wouldn’t turn off.  I got a few bits of sleep but not any long stretches, and certainly no deep REM sleep.  Essentially I didn’t sleep at all Wednesday night.  And that wasn’t good.

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