POST THREE: MENTAL HEALTH AWARENESS WEEK 2017

24 hours with... Nadine Appleby

Twitter: https://twitter.com/xnadine1990x

Date: Friday May 12th, 2017

Why have you chosen to write about today? 

I've chosen to write about today as there is a lot going on in my day I am currently an inpatient in an acute psychiatric ward and have meetings today with various professionals to decide next steps with my care.

Good morning! 

What time did you wake up?  '

6:30am

Why did you wake up at that time?  

The staff on my arms length observations made too much noise when they were switching staff.

Did you have a dream?  '

No a nightmare

Do you think today will be 'good' or 'bad' day? (use your own definition of these words to answer the question)  

I'm not sure I think it will hopefully be overall good but will have bad well very stressful parts to the day as I have been having a lot of difficulties with my mental health. 

What are the first three things you do after waking up?  

1.Check my phone

2.Make a coffee, 

3.Talk with the staff on my observations.

Pros & Cons of Being An Outpatient

Pros

Number One

Less pressure to be doing something constantly, which means I can have a day in bed without it worrying people.

Number Two

Not having to queue for my medication or having to take my night-time meds before eleven pm when I want to stay up late.

Number Three

Not having to spend my time doing something that I don’t want to do or that I will not benefit from e.g. some of the groups in hospital such as ‘Current Affairs.’

Number Four

Not needing permission to do the simplest of things; such as go outside, use a razor and see my Mum.

Number Five

Not having to open my post in front of someone, who then decides whether I can keep everything.

Number Six

Dolly!

Number Seven

No longer waiting for someone to look in on me so that hearing a noise in my home doesn’t mean it’s staff making sure I’m ok.

Number Eight

Fewer arguments in my day-to-day living. Less drama.

Number Nine

Not having to explain myself or beg for PRN medication when I’m especially struggling.

Number Ten

Being able to see my Mum and friends much easier than when I was almost 200 miles away from them.

Cons

Number One

That I can lay on the bathroom floor crying for over an hour and no one will know.

Number Two

That if I don’t take my medication, there’ll only be a fuss about it if I tell someone or if it affects me.

Number Three

I can self-harm and/or overdose and no one could know.

Number Four

I can silently struggle with hallucinations and there not be anyone who notices and suggests medication or a chat.

Number Five

That my best-friend isn’t two doors away.

Number Six

That I have to rely on my kitten to make me laugh instead of actual people; no playing pranks on staff or mattress surfing down the corridor!

Number Seven

There are no materialistic consequences if I self-harm or overdose e.g. I don’t get put in an empty bedroom, or stopped from going out.

Number Eight

Not being able to talk to and get support from the best Doctor EVER! Which means having no professional that I can be 100% Aimee with or who understands me almost as well as I know myself.

Number Nine

Feeling surrounded by professionals who ‘know’ me even less than the hospital staff did.

Number Ten

Only I can stop myself. And sometimes, I don’t.

I'm Sorry I Hadn't Noticed

So, I've just approved a comment on my blog that said:
'Hello Aimee, I don't know if it's just me, but you seem quieter lately. Hoping you are well and just to say on behalf of your readers, we're thinking of you. Xx'
To the person who wrote this; thank you. And to all of the lovely people reading this; I'm sorry. I'm not even that sure if I had actually realised how silent (we don't use the 'q word' in psychiatric hospitals; it jinxes everything) I had been on here... I guess I tried to distract you all from the lack personal detail with guest posts and I'm humbled and honoured that, at least for one of you, this didn't work. Sometimes I (and often people with BPD in general) 'test' family and friends by subconsciously pushing them away to see how far they will go.
So, I guess the biggest reason for my lack of personal posts has been that the main thing that's happening in my life right now involves another person who has asked that it not be made public knowledge. As much as I'd like to keep you all in the loop and brag about how amazing this person is, I have to respect the person's wishes, regardless of how much I might feel like I'm doing you all an injustice by not telling you about this important time in my life...

So, I'll update you all on the rest:
My meds were changed because I was taking 300mg Quetiapine (anti-psychotic) at lunch time and it was making me so drowsy that I had a set naptime but as I'm getting better mentally, this means I'm missing out on opportunities. So, I now take all of my anti-psychotic at night and at first, this messed up my mood. I was so scared because no matter what was going on during my days I was having the same pattern in mood; I'd feel a bit fed up through the day, suicidal in the evening and hyper at night. I eventually found the courage to speak to the Doctor and I decided to speak to her during the suicidal phase so she could see how bad it was... And when she popped to my room later on, she got to see how all those dark, scary, horrible feelings had just gone. Thankfully, it was just because of the meds change so a few days later and the pattern had stopped!
My urinary retention has still been going on... The Doctor told me on Friday (6th) that if I didn't pass any urine that day I'd be put on five minute obs because she said that me refusing to pass a catheter was a form of self-harm. It was hard because I had so many reasons for not wanting to pass the catheter and they weren't all connected to my desire to go into kidney failure and die.  But my desire to remain on hourly obs was greater so I managed to squeeze out a few mls but that was it for the rest of the weekend. Then on Sunday night, the 'uncomfortable' feeling in my stomach became a pain and I was put onto fifteen minute observations as well as having my physical obs done every few hours. Monday morning, I saw the Doctor and I told her how utterly shit I felt; she told me that she knew I was really poorly because I usually try to convince her I'm ok and 'it's not as bad as it looks.' So she called Urology and they advised I was seen on the surgical ward at the local medical hospital. I went there expecting a bladder scan, some good drugs to pass a catheter and discharged back. What I got, was a long wait, a bladder scan (I had 825mls in my bladder) and a Doctor with a plan. I had to have a catheter and go back to hospital with it in for a few days... I've never had a long-term catheter so I agreed to it and after sedation it was inserted. I think it was barely in ten minutes and I was almost in tears, agitated and triggered beyond belief. I demanded it came out and asked to be discharged. Ultimately, I'm glad it happened because I now have the determination to try harder with inserting catheters myself so that I avoid a repeat of this.
I also want to avoid a repeat of this lack of blogging.

The One Where Henry Gets Bad

This morning, it was loud. The auditory hallucination that's the most paranoid had jumped on me out of nowhere; for a while now it's felt like my brain is separated into these little compartments with each of voices and me taking up space. And after a lot of hard work I've finally managed to occupy the most space in head and to build my walls to high so that an invasion from one of the voices is unlikely. But I guess, like all good armies; my defences were weak whilst I slept and I woke up to find that Henry had invaded my compartment.
I felt a bit stupid and naïve at first; I thought I was the expert in dealing with my hallucinations by now and I thought that I should've realised he was building up to take-over. For weeks now, he's bugged me with his delusional, paranoid thoughts about how a previous medical admission was a chance for the government to experiment on me and when I found a random doddle in my book he told me it was a message from the spies. Whenever he's said anything I've wrote it down so that I can see how irrational and unlikely it is and then the Doctor reads it.
This morning, his thoughts mainly centred around these calls I've been getting; an Unknown number rings and if I answer there's some deep breathing for a  while. Henry thinks he knows who it is and that means that there's someone here at the Hospital who's betraying me and going to this other person. So many things were happening that were ending up working out as ammunition for Henry and so it didn't take long this morning for me to have gotten completely lost in his thoughts. So I asked to speak with my Nurse and I told her everything he was saying and how he was making it difficult for me to take my meds because he was telling me they kept giving me them to cloud my judgment and mask what they were really up to. My Nurse talked things through with me and then she got me my morning meds and said she wanted me to take my PRN anti-psychotic.
For the beginning of the morning I felt like I was in a daze and it was a relief to go to Creative Writing Group and have something to properly concentrate on whilst I had company. After group I was back in my room, where Henry's voice seemed to completely surround me. I tried turning the volume up on the TV, I tried ignoring him, I tried negotiating with him and I tried to distract myself. Nothing worked. He was persistent and the urgency in his command was growing; I had to hurt someone. He said that if I threatened to hurt one of the staff then they'd have to confess who was betraying us. Yes, 'us,' he made it seem like he was on my team and that it was 'us' vs them. He was clever about it and when I started having visions of me holding something sharp to someone's throat, I got scared. I spoke to my Nurse again and told her what he was telling me to do and how I didn't want to. She went and asked the Doctor to come and see me. To be honest, I'm not even sure what I said, I just know it worried them because the next thing I knew my bathroom was being locked and I was on five minute observations. There's a difference between disassociating and getting caught up in auditory hallucinations. I was the second one.
My Nurse brought the Psychologist to my room but I felt like telling one more person about Henry would give him more power; as though he'd get a sense of self-importance the more I talk about him. So, I had a lie down. And as suddenly and quickly as he'd came along, he left me and I was back in control of the majority of my head and left with the aftermath of his invasion!
I explained to my Nurse and the Doctor how I needed my bathroom unlocking especially considering my recent health problems so that was done and then I found out I'd been put onto five minute observations (the worst you can be on, on our ward). The staff explained it was to support me more and agreed to review it before the end of their shift. So, after my nap, I chatted with the Doctor and explained how supporting me meant talking to me when I come to them and not looking through the window in my door every five minutes. I told her that it felt like a punishment and had made me reconsider being so honest and open with them if this was going to be the result. I've become somewhat of a perfectionist (unsure if that's the right word) and I hate being on obs any less than hourly, no matter how long for. But I had to see it from the staff's point of view and eventually we agreed I'd go onto thirty minute obs for the night and tomorrow morning they'll be put back to hourly.
I'm glad the day is over but in a way, I'm kind of glad that it happened. When things are going along swimmingly for a while it makes you a bit complacent so I guess it's sort of nice to have a reminder as to how grateful I should be for this settled period. And, also, it was a little reminder that the staff are still here for me if things go wrong. Sometimes, when you're doing well you feel as if the staff aren't too bothered with you. It's also been a bit of a step further up my ladder of recovery because not only have I been honest about what I was struggling with, took staff's support over meds and accepted their ideas to support me, but I've also took positives from the situation.

My Obs Stayed The Same

My last Ward Round the plan was to change my obs four days later and let me go on Home Leave that weekend. Did it happen? Did it fuck! (excuse the language in this post but I'm pretty damn furious!)
I've now had two nurses telling me I should be on 30minute obs so on Monday I fully expected my obs to be changed in zoning. But they didn't do zoning. They didn't do it yesterday either. Today, I had my hopes up. But the staff just told me they didn't change them. I couldn't believe it!
These past two weeks, I've stopped eating for four days, I've started hearing a new voice, I've had my first tactile hallucination and I've been let-down numerous times by staff making promises they couldn't be bothered to keep. My point is, I've had all this shit and I've not self-harmed. The lectures and support with the eating wasn't helping so I gave myself a stern talking to and put a stop to it myself. With the voice, I went straight to a nurse about it. With the tactile hallucination, it made me question a lot and my trust in staff wavered but it lasted days and I took the first step in speaking to staff about it. And when I've been let-down, I haven't lost my temper or mouthed off at staff; I've gone to my room, cried and ranted to friends. I've also had this massive sadness inside of me; it swells up and feels like there's a cloud above me and that everything is grey and bleak. I've barely managed to enjoy anything I've done and there've been times when all I've wanted is to feel some pain to stop from feeling all of this sadness. But I haven't. I've used DBT (Dialectical Behaviour Therapy) skills and grounding techniques. Even today, when I was struggling so badly with the voices that I went for PRN but before the Nurse could get me some a doctor took me into a room and quizzed me things. While she was talking I found myself scratching furiously at me left arm to the point where I drew blood. She stopped me and said we needed to stop talking so that I could get meds. I told her I felt like I could manage it myself now but she was adamant and was convinced I was going to go to my room and self-harm. I refused the medication, went to my room, scratched my arm a bit more, cried then lay on the cold bathroom floor and took some deep breaths. After about half an hour, I went for my dinner and took my usual 6pm meds. I was so proud of myself but all of this effort feels completely wasted when the staff aren't even acknowledging it. Instead, they've told me today that everyone is concerned about me because I usually attend and participate in all my groups but yesterday they said I didn't go to groups (they were in the sun in the courtyard all day and I had a migraine) and that I didn't participate in any today. It's like nothing I do is good enough. It makes me wonder why I don't just self-harm or do what the voices say. It makes me wonder why I bother. The staff are quick enough to punish you when you self-harm or don't co-operate but you put a bit of effort in and work hard and it takes them a bloody month to even realise!
Luckily, it's Ward Round again tomorrow so I still have the chance of changing my obs and getting my Home Leave this weekend but it hurts that I have to persuade them to change my obs and beg and plead. And I don't know how I'm going to cope if they still say no.

The One With All The Conditions

Today was ward round day. Everyone hates ward round day because one of two possible things happens; either you get exactly what you wanted with a catch or you get nothing you request and the whole thing is an absolute shambles and you spend the rest of the day crying and struggling. If you're wondering, my ward round today was the first option.
I requested for my obs to be increased to 15minutes (I was on 5's). That was granted. I asked for my one-off local leave that you're entitled to on fifteens to be on Saturday with my Mum. That was granted with a catch; staff have to come too and I only have two hours. And I asked for my home leave for the 30th to be written so that it can be organised in case I'm on 30's by then. That was granted. And then came the big catch. Increase of medication; the Doctor said that just because I'd been fine for self-harm since I went AWOL didn't mean I was ok; she said my moods had been fluctuating and I'd been struggling with the voices and asked my another Doctor if they should consider a mood stabiliser but he said to increase my anti-psychotic by 5mg and then if that didn't sort out my moods they'd put me on one. When I thought about it though, it's not such a catch... I mean, yes it means I will only still be on 15s and get the leave if I continue to fight the voices and take my meds but that shouldn't be so hard since it's only one extra tablet with the other two, it's not like they've spaced them all out since Aripiprazole is a stimulant so I have to have the full dose in the morning.
My RC suggested the staff get in touch with the Hearing Voices Network too (http://www.hearing-voices.org/), saying that they have a 'fantastic' Psychologist who is 'amazing at convincing people not to do what their voices tell them.' He also gave me a lecture (he loves his lectures, he has one for me every ward round) on trying harder and fighting harder! I wasn't best pleased with this; the thing is, I only go to staff when I'm about to lose the fight with the voices and at risk of doing what they say, I get meds off staff or have a 1:1 to talk it through. This means, they assume they know every time I have to fight. They don't. There are plenty battles that I win which means I don't need their help or support so they don't find out. I tried to explain this but just ended up asking him if he'd ever heard voices and telling him since he hadn't (obviously) he had no idea how hard it was and if it were simply a case of trying harder, if it was that easy, then I'd do it in a flash and I wouldn't BLOODY be here!!!!
Something to cheer me up; best-friend bracelets off CS (by the way, the abbreviation is ironic since staff refer to us by our initials to avoid breaking confidentiality). 



 And now, since the alarms are quite obviously broke, we have to listen to the staff pratting about with their new toys (walkie-talkies) all night. Over and out!