They Said 'Renal Failure'

So I had Ward Round today.
I was actually excited for it because I planned to request leave to go see my best-friend; Chels and I was dying to be able to tell her I could definitely come and have us both scream down the phone. So, my main worry for the ward round was not being granted that; I'd read my Ward Round summary and it wasn't too bad. The worst bits were that I'd worried staff with my dip in mood (a result of this thing I can't broadcast to the world) and that I'd been hospitalised twice for my urinary retention.
I had a plan up my sleeve if my mood was mentioned because I've reacted completely normally considering the situation. And that's what I said when they asked why I don't like to admit that I'm not always 'ok.'  
For some reason, I didn't for one minute, think that the urine thing would even be mentioned let alone discussed! I guess I just thought the whole issue was under control; like, there was an understanding - I needed to try harder to pass catheters and be more honest if things begin to go wrong. But I thought that was it. Apparently not. They talked about how some people have trouble weeing and it could be because they're anxious, feel rushed or there's lots of noise. I was told to take some 'quality wee time' to just sit on the loo. And that was me done! I told them it was unfair to talk about this sort of thing especially in Ward Round where there was someone who wasn't involved in my care and staff who I didn't want to discuss this in front of. I was told 'I know it's hard to talk about' and I explained it wasn't 'hard' it was 'embarrassing.' So I managed to get the topic changed and we begun talking about my leave requests which got me a brief comment about whether my refusal to pass catheters was classed as self-harm. I told them that there was only so many times I was going to explain this and repeat myself and told them I'd rather talk about it in private. And then, out of nowhere, I was told that I have to have blood tests done once a week because they're so uncertain about all of this urine stuff and they can't rule out me going into renal failure. They told me they were worried that I wouldn't speak up if I felt poorly and they didn't want to risk it going too far. I cried. I wasn't really sure why, so when a Doctor asked me, I didn't reply. Afterwards, I thought about it and I think it was because it was such a shock. No one told me that sort of thing was even being talked about and then it was just sprung on me when I least expected it. And also, it kind of ruined the ward round; I ended up getting the leave to Chelsea's granted and I couldn't properly celebrate it. And when I told her, I also had to tell her about the blood tests so she was crying too.
And now, I'm being told I can only see Chels if I have my bloods done and they're ok and because I have such shit veins, I'm having to go to the local medical hospital to have them done tomorrow morning in the hope the results will be back before the day's over so I can see Chels. I'll go to any lengths to see my best-friend though.

What's In My Way?

Recently I've been thinking a lot about my discharge. At my last CPA (Care Programme Approach) in November my Consultant estimated it could be another nine months before I could be safely discharged...
I started buying things for my own place when I get discharged, I even have colour schemes for each room and I have some lovely things for the kitten I plan on buying! I've begun applying to courses at colleges back near home as I plan on moving that way when I get discharged. And I've even made some connections with mental health people back up North in preparation for my job search!
All of these preparations have helped to excite me about my future and remind me how badly I want it but now it's time to think what's stopping me. What are the things that are still in my way, preventing me from discharge?

1. The voices; I'd prefer it if they were very quiet or non-existent upon discharge
2. The rabbits; if they can't go completely then I'd like to be able to manage them, no matter how many there are
3. When the opportunity arises my first thought is to run or self-harm, if it can't change then I'd like to be 100% confident that I can keep myself safe no matter what
4. I have things from my past that need to be worked on

Yesterday, it was Ward Round and I asked for my unescorted leave back, telling them that I feel that is the biggest thing slowing down my discharge. My Doctors disagreed. The Ward Doctor didn't think I was ready to be having my unescorted and my Consultant thinks we're still 'miles away' from discharge.  They both told me not to rush things and I was just sat there thinking "why the hell would I want to prolong my stay here?!" I got really upset in the end and it wasn't so much with the fact I wasn't getting the unescorted back but how far away our opinions were. It's so frustrating that no one is bothered when I'm planning things but when I'm actually getting better and have no plans and no desire to make any, everyone is suspicious. I just want to be out of here already and living!

I Got My Unescorted Back And We Planned Flooding

Today, I had my first Unescorted Ground Leave since the overdose in October. The Doctor wasn't too happy about me using it and in all fairness, I had agreed with her that I wouldn't use it until she was happy but I really just wanted some time away from the ward and four of the girls wanted to go with me. It was lovely that when the Doctor was deciding if I could go all of the girls begged her for me! She took me into the Meeting Room and asked why I was suddenly wanting to go out and I told her all the upset that the staff have caused me recently and that being unhappy didn't mean I was unsafe. She made me look her in the eye and tell her I'd come back and eventually, she was reassured that I was going out with the other girls and wouldn't run from them.
We all had a lovely 15minutes, having a giggle and a sing. The smoke shelter we had to go to so that the other girls could smoke meant that the fence I've climbed over to go AWOL was in sight. And all of a sudden things were loud and it was surprisingly difficult not to just make a run for it. I didn't want to, but that stopped being a good enough reason not to because it was that loud inside my head. So the things that stopped me running were the thought of doing that to the girls I was on the leave with and the practical point that I didn't have any money on me so I wouldn't get far.
When we got back to the ward, things got a little louder as I was shouted at for not taking the opportunity and I had to make a decision. Could I bare to lose face in admitting the Doctor was right? I had to; I know that if I want to get better than I need to be as open and honest as possible with that kind of thing so we had another chat and I told her what'd been going on and agreed that I wouldn't ask for the Unescorted more regularly (today's was a one-off) in my next ward round.
My flooding was also sorted today. A little while ago I had the leave written up for me to visit the place my trauma took place but the Ward doctor and Psychologist weren't too certain I was ready to do it so quickly. A lot of 1:1s happened and I convinced them I need to do it now. So in Ward Round last Thursday, I got the date agreed that we'd go on Friday (21st) but then the Doctor changed her mind and in a haze of tiredness, I agreed to leave it until she thought I could manage it. And then I went home...  While I was there, I wrote the Doctor a note about how things weren't changing on my home leave; I still get these irrational, impulsive moments when I want to just go to the place but I can't and I feel like every second I have those thoughts whilst I'm home, is time wasted. Luckily, the note had the desired effect and the Doctor booked the vehicle today for us to go on Friday. I know people are expecting me to be really anxious, nervous and reluctant or what have you but I'm actually excited. The way I see it; the sooner I do this, the nearer I get to recovery and discharge.
Bring it!

This is a Ward Round...

I wanted to give you all an insight into our Ward Rounds...
It starts with a Ward Round summary written by any given Nurse and at any given time though it's meant to be your Named Nurse and at least 24hours before Ward Round.
So, my summary for tomorrow (09.01) was written by my Associate Nurse and I had the option to comment on each sections. It reads like this...
My Mental Health Recovery
Staff Views: 'Suffered from hallucinations which lead to Aimee self harming by throwing herself from the toilet. Aimee wrote distressing things on her mirror but a day later removed this herself and replaced it with positive things. Aimee suggests she feels lonely.'
Service User Views: 'I did, under no circumstances, 'self-harm.' An hallucination promised to catch me but obviously I realised too late that he was an hallucination. Once again, you've all misunderstood, I was trying to keep myself SAFE, not, self-harming. I'd also say it was normal to feel lonely when you're miles from your family and best-friend!'
Stopping My Problem Behaviours
Staff Views: 'Aimee self harmed (above) and is eating minimal amounts. When offered tablet paracetamol as PRN Aimee refused and requested liquid!! :D'
Service User Views: 'As above! Also, my diet is obviously adequate since I am maintaining my weight!
Getting Insight:
Staff Views: ' Aimee finds it hard to distinguish reality from hallucination at times, but generally shows good insight into needs. Very poor self image.'
Recovery from Drug and Alcohol Problems:
Staff Views: ' No access to drug and alcohol on ward.'
Making Feasible Plans
Staff Views: 'Aimee has plans to work.'
Staying Healthy
Staff Views: ' Very little to eat. New glasses, so fewer headaches. Hip pain gone. Bruising easily. Good meds adherence.'
My Life Skills
Staff Views: 'Aimee has become very isolative but uses time on her own well.'
My Relationships
Staff Views: 'Good with mother. Continues to speak to Chelsea but declined to discuss how she was in an abrupt manner. Grandad getting married which may upset family, but Aimee is taking quite well.'
Service User Views: 'Me refusing to tell the entire ward how Chelsea is doing should, under no circumstances, be mentioned in MY ward round summary. Irrelevant! Also, my Grandad is engaged - that doesn't mean they'll get married.'

And then it's Ward Round...
I must admit, I had originally planned this post because, after reading my Ward Round summary, I had assumed there'd be some heated discussions in the actual meeting and that I'd have something to have a good rant about... Now though, this will be a good post in showing how unpredictable things are here because regardless of my summary, the Ward Round went fantastically! My Consultant asked about my Christmas home leave and I explained that it'd been a little harder towards the end but that I hadn't needed PRN or to come back early so he said that was a massive achievement. Then he asked what my requests were. I mentioned leave for College (I've applied for three courses that each run two hours a week) and the Nurse said it'd be hard to organise one of them because it's right on handover but my Doctor said that they should take into account that this is what they've been working for me to do and that I'm doing really well and it's important I get to do this. So he said to leave that with them. Then I got all my other leave written up; home leave next weekend (an overnight drop-off), leave to go to London on the 22nd for a conference, and home leave for my birthday (31st-2nd Feb). I also told the Doctor that I was using my PRN quite often and without hesitation or questioning they increased my anti-psychotic by 50mg.
It's times like this when you really see why it's important not to give up at the first hurdle and assume something will end badly so that you don't even bother trying.

I Begin An Anti-Depressant

So I was watching a film and then something in my head clicked and I suddenly thought 'I can't make it through the weekend' so I went to the staff office and luckily the doctor was in. We went into the meeting room and I told her I wanted to start a medication for my feelings. I explained to her how I feel like a black cloud is hanging over me and I'm spoiling everyone else's day, I told her how it feels like everything is black and white and grey. The colours have all gone. I explained that I used to get pleasure from doing my portfolio but even that doesn't make me happy. I told her I can laugh with people at jokes and things but then it's gone in an instant. She asked if it had anything to do with how loud the voices were but I said no because it feels separate, and even when they're quiet or not too nasty, I still feel sad. I admitted that to get to sleep I think about suicide and self-harm because it calms me. I told her that I'm safe though because this sadness feels so deep that I can't imagine self-harming would make a difference or help.  The Doctor told me to stop worrying about my obs and leave because she said these feelings and things are more important. Then she asked why I hadn't mentioned all of this in Ward Round because my Psychiatrist was there so he could've prescribed something. I told her I didn't want people to think I was weak. She checked I would get through the weekend and advised I take my sleeping tablet every night and use my PRN anti-psychotic then she'll ask my Psychiatrist to see me Monday to begin an antidepressant. As soon as she said that I felt a weight lift from my shoulders. It was such a relief to know that I won't have to feel like this much longer.

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!

I Have To Make Some Decisions...

[note: this post contains discussion of suicidal ideation]

This morning while I was getting ready I started making plans. I didn't mean to. My head was noisy... To the point where I couldn't tell the difference between their voices and my thoughts. They all became one. So I started planning my escape route to run off when I had my unescorted ground leave to go and overdose. I didn't want to do it. Yet I was making the plans. I was thinking about how I'd gotten away with it two times already so I might as well go the same way. I was worrying I'd get caught before I got in the taxi and it would all be a waste. And then I realised; I didn't want to do it. I felt sick with the thought of all the tablets I'd have to swallow before the voices went quiet. I felt shivery at the thought of the horrible anti-dote I'd end up having when they found me. Because they always found me. So what was the point? Were the voices  that bad? Did I really need to do it? I went and spoke to one of the staff and told her I shouldn't be allowed out today. She asked why and I explained then she told me it was 'really brave' of me. "Or stupid!" She shook her head and promised to support me if the voices started getting nasty at me for speaking to staff. Then I went to group. Just like that. At first, my smile was easy to rub off as the voices went on, and on. But then I got more determined and began to feel like a weight had been lifted at the thought that I wouldn't have to overdose today. It was such a relief. I'd never felt like this before; I mean, it wasn't often I stopped myself from overdosing but when I had done I'd always regretted it and ended up doing it the next day because my head had gotten so loud.

[note: As I'm talking a lot about the voices, I thought I should describe them to you. There are three; Albert, Annie and Harry and I know it sounds strange that they have names and I know it sounds crazy that I hear voices no one else can but it's not so mad. The explanation I have for them is that as I disassociated during my 'trauma' I am now disassociating by hearing them and having visual hallucinations. The best way to describe them is like headphones. When you listen to your music through your headphones and the sound is going in through your ears yet it somehow fills up your head. Each voice has it's own personality; Albert is the one who tells me what to do, Annie is the one who comes up with the sneaky parts of the plans and Harry is just some random, excitable child who loves the adventure of an overdose. They are inside of me but they're not part of me. Don't feel bad if you still can't  comprehend this; it took me about two years to grasp.]

I sat through one of my groups and when things got louder I reminded myself I'd be taking my anti-psychotic in an hour anyway so there was no need to ask for meds. I managed. And I'll do it again and again for as long as I can.
I'm still happy with my decision to tell staff and I need to keep reminding myself of this feeling because I can still feel plans building up for tomorrow so I might have to stay in then too. But it'll all be worth it in the end if it means I get to live my life.

The AWOL Procedure

[note: this post contains discussion of suicidal ideation]

Sorry it's been so long since a blog but not a lot was happening and then all of a sudden a lot happened!
On Sunday 24th I went on my home leave and when I was packing a bag of more clothes to bring back, I picked up a pair of bed socks they felt heavier than usual and I felt something hard inside them. I found two big pieces of broken cup, still with blood on them, I knew that in the community I used to hide pieces in my bags so that if I went out it didn't matter which bag I took, if I needed to cut then I would have something. The fact I'd put stuff in my socks... It made me sad to think it must've been that bad. I must've been that desperate at one point. I gave the pieces to my Mum and she told the staff who said how good it was that I'd admitted to them and not tried to sneak them back to the ward. This, sparked up the voices; they shouted at me for handing them in, they said I gave in too easily and that I'd regret it when I got back to the ward and needed to cut and had nothing; they'd make sure of it. They got louder and louder as we drove back to hospital and we stopped at some services so I could get a drink then the staff gave me two sedative tablets and when I carried on crying they gave me an anti-psychotic which helped me calm down and get some sleep for the rest of the journey.
Back on the ward, I decided to run away on my unescorted leave and overdose. The voices were telling me to do it and they'd been so quiet for so long and things had been going so well that I was sure I was getting better and now I was back to the start... But it felt different this time.
I went out first on my escorted local leave where I went to Asda and withdrew some money to pay for my taxi away from the hospital then at about half two in the afternoon, the same day, I got signed out on my unescorted ground leave; I called a taxi company as soon as I'd walked past the staff office and then headed round the back of the building. I was almost at the low fence that I'd jumped over last time when I realised the PICU (Psychiatric Intensive Care Unit) were having their smoke break so I had to wait until I heard them go back in then I was literally inches from the fence when a member of staff started making her way to the staff smoke shelter and I stopped in my tracks but she didn't notice me so I jumped over the fence; scratched my knee in the brambles I landed in and grazed the top of my thigh on the fence but I ignored it and kept running across the path of the old people's home who's garden I'd jumped into, jumped over a fence into a person's garden and walked down their side path, through their gate and across the road to the newsagents. I bought tablets and got my taxi to a nearby city. I bought more pills there and carried on taking them throughout the afternoon, I took a bus to a town an hour and a half away, then went back to the city where I swallowed the final sixteen tablets in one go in the train station toilets. The voices went silent instantly and I felt myself again; for the entire overdose (six hours or so) I'd felt like a zombie, walking around in a trance, taking tablets without thinking. It felt like I was one of the voices; Annie - I didn't care about anyone, I didn't care about myself, I didn't want to be alive. Now I was Aimee again, I found a member of railway staff and asked if there was any police in the station, I explained I was a missing person and he took me to the British Transport Police station just next door. They asked where I'd runaway from and if I'd hurt myself then called an ambulance and asked more questions while we waited. They followed the ambulance to the nearest hospital and two NA's from our hospital came to swap with them. The Doctor took my blood and managed to put a cannula in a vein right on my knuckle which meant a nurse had to bandage two of my fingers together to keep it in place while I was connected to the anti-dote drip. They switched the first drip bag over from going through in fifteen minutes to taking two hours, then I had the second one over four hours and was moved up to a medical ward but there was no beds so I had to stay on the A&E trolley in a room. It was so uncomfortable and I hardly got any sleep but I got on well with the two NAs that were with me so we chatted quite a bit and played eye spy before they swapped with day staff. The voices started getting loud again just before I was moved into a proper bed and a nurse went to get me an anti-psychotic and a sedative but they got really bad, really quickly and I stopped the machine on my drip so the treatment couldn't go through and then when the nurse came with the tablets they all told me that I'd be restrained to have the treatment and that I wasn't allowed to discharge myself and the voices and I got angry so I tried to take the drip out and was squashed to the bed. Someone injected 2mg Lorazepam (a sedative) into my cannula and I felt sleepy but I must've still managed to get the cannula out in the end because while I was sleepy a Doctor put another cannula in my other hand. Within an hour it was bad again and I'd pulled the drip out of my vein so that all of the fluid collected in my hand (it's still being absorbed!) and they injected me with 4mg Lorazepam and an anti-psychotic. Security were called to swap with our staff and give them a break and they were a lot more careless about how they restrained me and how much pressure they used. A Doctor tried to get another cannula in my foot and at one point about six staff were holding me down while she tried to avoid me kicking out at her. She failed three attempts on both feet so they took a blood sample to see if my levels of paracetamol had gone to a safe level, it took about five hours before a Doctor came and said my clotting levels were abnormal so he took another blood sample from an artery in my arm. While we waited for the results (by this time I had the NAs who'd originally been with me back) the female NA came to the bathroom with me because the Doctor had got me a razor and the nurses got me wash things so I had a shower because I knew I wouldn't be able to have one when I got back to our hospital and I didn't want to go to bed feeling all scruffy. My results came back fine and at 3am we came back to hospital.
I had ward round today and at first, I was told me to try harder and to be more honest and I told them I'm honest all the time until I need to do something and then I have to lie through my teeth so I can do it. I'd wrote a letter and one of the staff asked me to read it but I refused because I said what was the point in pouring my heart out to someone who didn't have a clue. They offered to read it, and then the SHO offered and I was worried that if I read it and they still had no clue I'd feel even worse but I thought at least I would've tried to explain. So I read it out:
'I'm afraid this might not make much sense and it'll probably be difficult to understand but this is how my life's been for the past five days and I'm having so much difficulty understanding it myself that I'm struggling to explain it to anyone else.
Rather than just hearing Annie and Albert, I feel I become them now. Originally, it was a case of me having to balance keeping Annie and Albert happy enough so that they're not angry at me whilst staying safe and alive. And I can't always get the balance right and I don't always care or want to because it's so much less effort to give in.
I used to feel like even though I was doing what I was told by self-harming and overdosing I've always known I didn't properly want to kill myself, but not every inch of me wants to fight Annie and Albert and not every inch of me wants to lie still and accept help. And those parts, want what they want whole-heartedly. So not only have I had to fight against the voices, but I've also had to fight against a piece of me I hate to acknowledge exists, so forgive me if I occasionally slip and lose the battle but it's very tiring.
These past few days I've not felt like myself; the voices have felt powerful and unstoppable. On Tuesday, it felt like they were so strong that I actually became them - there was no longer the me who didn't want to kill herself. My head wasn't consumed by their voices, but by their thoughts... It was physically exhausting and I don't know what I've done wrong or what I did to deserve it. I'd thought I was getting better - I didn't lie; the voices were quieter and I did stop wanting to overdose. Up until Tuesday, I was honest but I had to stop so that I could do it. I felt terrible, I feel like I've let everyone down since they had only just begun to trust me again. I can't stand the person I become when I run and overdose so I wonder if the only way away from this is to die. I'm tired of living and these past few days things have gotten worse and been hard, it's been enough to take all of the hope I'd built up over the past few months.'
The room was silent, they all looked sad, and then my Doctor said it'd been really powerful and that they'd needed to hear that because it'd helped them understand and that he knew they'd never fully understand because they can't hear what I can but it's helped them appreciate how hard I try. I was so pleased and happy I'd ended up reading it out. They didn't give me the leave for mothers day that I wanted but I had a feeling they wouldn't because it's not long away and I'm on five minute obs now and you can't go on home leave until you're on at least half hourly so they gave me leave for the weekend after and my Mum is happy with that but I'm still disappointed in myself.

'I've been trying to do it right, I've been living a lonely life, I've been sleeping here instead, I've been sleeping in my bed, so show me family, all the blood that I can bleed, I don't know where I belong, I don't know where I went wrong' - The Lumineers - Ho Hey