Rambling 48

Just finished watching my Sox defeat the Yankees. So sweet. Lester pitched good.

I was hoping to do some soul searching today but I am wicked cranky. It took me forever to get to my Starbucks today because I didn’t look at the bus schedule and had to wait almost 45 minutes for the next bus because I missed the one I thought was at 10:40. There is no longer a 10:40 bus on Saturday! OOPS. I then walked down College Ave, which is probably like 1/8th of a mile to reach the next bus stop. I made it there in plenty of time to catch the 12:30 bus back home. There was a lot of traffic on Broadway today so bus was kind of late. More waiting around and of course I was standing for most of it. My ankle just “loves” me right now (being wicked sarcastic here). I came home to listen to the ball game but wanted to watch it instead so made the trip down the stairs and tried to put my feet up the best I could. It wasn’t easy as the announcers on FOX suck and I kept on getting aggravated.

It is cool today so I have the ceiling fan off for the first time all summer. I am feeling low despite the win today. I don’t know why. Probably because I have cramps and I know I am going to be hurting later today, possibly. I never know I did too much until later in the evening when I want to settle down and go to sleep. Seems like nerve pain always waits until then to bother you.

I am having trouble remembering what I did with a book I need to write about Aeschi model. I want to read a little of it but can’t fricken remember which bag I last had it in and I am too tired to go perusing. I guess I could just go to the Aeschi website and read from there as a last resort.

This morning on twitter Mayo Clinic had a suicide chat talk. I missed it because I didn’t get up till after it was over, which is too bad because I was very interested to see what Dr. Tim Lineberry had to say. He was one of the docs that has worked with David Jobes in using the SSF (suicide status form) on inpatient units. I met him last year at the annual conference for the AAS. He is an ok guy. He was one of the moderators for the Aeschi workshop I attended. But you could tell, suicide was not his favorite type of subject. It is just an occupational hazard, least that is my impression of him. I think the transcript is online somewhere and I might just check it out.

I have told my writing partner that I am just going to take Saturdays off from writing because there are too many games to watch. I have my college football games and my baseball to watch. I didn’t see too much of the Nebraska game but the parts I did see were ugly. UCLA came back after having a 21-3 deficit. Nebraska lost 41-21, much to my chagrin. They wore awful home jerseys so I am blaming the jerseys.

The flux in temperature this week has my back in agony. Between the thunderstorms and the drop in temp, I am hurting. It has been a long time since I have had back pain from the weather so I know this can’t be good. I really hate having back pain because it limits me more than my ankle pain. Right now it is just aching and I hope it stays that way. Last thing I need is for it to go out on me and me being really laid up.

Since my new laptop has been shipped back to Dell, I haven’t been playing my Facebook game too much. My old laptop just can’t handle the graphics to well and is very slow in trying to run. I am so bummed. I have played this game every day, couple times a day and to go from that to minimal play is killing me. I am so going to get behind on my missions. I still try to get the stuff I need from other players but they have new stuff and I know it is from new missions that I just can’t access right now. I am frustrated. My concentration has been kind of on the low side of things so I haven’t read anything in the Lincoln book in the last two weeks. I am up to page 566 and still have at least two hundred more pages to go to finish it. I just can’t bring myself to actually read and that is more frustrating to me than anything. I hate leaving a book in the middle.

I tried to watch the season finale of Bones today but after the baseball game, I was wiped and couldn’t sit anymore. I got restless and had to get up. I can only watch so much TV before I get bored. I really need a nap.

blah 3

Ever had one of those days where you just feel blank? Like nothing is going on inside your head, no thoughts, no feelings of any sort, just feeling blank? Or have those days where nothing tastes right? Yea, I am having one of those days. I tried to make it a good day but I just feel so blah, like everything is an effort.

I got my hair cut today and I thought I would feel better but I didn’t. I waited around for the bus to the Square to get my coffee and decided to get Mexican food instead of a pastrami sandwhich and it just didn’t taste right. I had half of it then threw it away. I then got my coffee, a pumpkin spice latte, iced and a pumpkin scone. The scone was edible. It was okay but the latte was terrible. I don’t know why but it just didn’t float my boat today. I drank half of it and tossed it. I just was not in the mood to finish it.

My therapist was able to fit me in her schedule today. I guess I should talk to her before the weekend. I hope that I can explain this blank feeling to her. She probably will just say ah ha. And that will be that. I hate it when she says that. I’m going to try and talk about the grief of not working. I think I am having a bout of it today. A friend of mine I used to work with is on twitter and still works in the lab. I miss working with her. She always made me happy when I was grumbling at work. It made the day go by faster because we would have a good laugh to ease to the tension of the work day. The job was stressful. We were responsible for people’s lives as we were the ones to order lab tests the doctors had ordered. If we ordered the wrong test, which happened occasionally, it would suck because it could delay treatment of the patient. I miss it, but I kind of don’t miss the stress of it, especially when it came to pediatric tests. I always felt bad when a little one was sick. Sometimes the nurses drew too much blood or not enough, mostly not enough, and expect us to perform miracles on a tiny drop of blood. I remember we had a newborn who needed a glucose and the nurse sent us the sample like three times and each time was the same amount of blood. She didn’t understand that we needed at least a half a tube of blood to get the test done. The worst part was that the parents were lawyers and were threatening to sue or cause something because she had to repeatedly stick the baby. I felt bad but we need more than a drop of blood to do our job.

We then had funny diagnoses from the ER. My favorite were the ones that came in because they were drunk and fell. Well no shit. Whoever drinks to the point of alcohol poisoning is going to tip over and get hurt. It really sucked when it was a young person. You just knew they could become alcoholics if they weren’t already there. But it was interesting working in the lab. Got to see some really cool specimens and others that were just beyond gross. We once had a sample that was supposed to be urine but because the patient was doubly incontinent, we got both stool and urine. And it stunk really bad. When I called to ask the nurse about it, she just said do the best we can. Yea, hold our breath as we analyzed it and hope we don’t pass out!

I wish I could remember the fun times in the lab. We used to have a lot of fun until a certain supervisor got jealous and made us stop. She really was a bitch though she would always play the injured party when caught. I always tried to keep my “good” side with her because she was such a backstabber, but toward the end of my days, it was getting harder and harder to do. She realized how much of an impact I had when I was there and soon laid off her phoniness with me. Not like that made things better, but it was a step up. I remember there was a time we played a joke on a friend. She had injured her foot in a car accident and took her sneaker off. Well, a coworker and I decided to hide it on her. When she came looking for it hours later, we made up some story that we used the pneumatic tube station and tubed it to blood gas. (it was still in the front office where we were but didn’t let her know that). She hobbled to blood gas looking for her sneaker while me and the other coworker who was in there just laughed our asses off. We actually forgot where we put it, until we went searching for it ourselves. The expression on her face was priceless. Those were the good days. We got the work done and still had a few laughs. Then the lab changed and so did the laughter. It was just work, work, work. Sure we would still have our breaks and such, but damn, it was hard keeping up with the patient’s samples coming in and not enough people to log them in. There were nights we had to leave the outpatient samples for night shift. We could only do so much in eight hours. And computer downtimes, scheduled or unscheduled were always a bitch. You always got that one not so understanding clinician who wanted his stuff above all the others just so his shift could come to a close. We would go out of the way to find it and then find out that there was another doctor covering him. So much for it being a priority!! I would get so pissed off.

There were days I would just get to work and be in a bad mood. Saturdays were the worst. If day shift left us outpatient bags, I was even in a worst mood. Plus they always seemed to wait for me to come in and hand off the problems that should have been dealt with hours ago. I had a rule of not talking to be until after six o’clock, because by then, things were caught up and day shift was really gone and all the problems have been dealt with. But never failed that a half hour or even fifteen minutes before my shift ended more problems would come in and I would have to stay on till exactly midnight or after to make sure they were dealt with and handled properly. I always made sure things were clearly documented so the supervisor would know what was going on. And in my line of work, you had to be clear otherwise mistakes would make the mistake worse.

I liked my job. It was routine. I was the one that was there the longest and knew the system better than anyone (other than the computer staff). I also helped where I was needed even if it wasn’t my “job” for the day. But things got more difficult the more my mobility slowed me down. When we had the big analyzer machine installed, I found I couldn’t run it and aliquot specimens in the same shift. I would be dead the next day and often it lead to me calling out on my next scheduled shift, which I rarely ever had to do. Once I stopped having a car, getting to work on Sunday was getting to be impossible. I was late and it took me over two hours to get to work, by public transportation. I just said the hell with it and worked during the week and Saturdays. Sometimes, I would work only half shifts and even those were painful. I sometimes had to leave my shift in a wheelchair or half way through, go down to the emergency room because the pain got to be so bad I could hardly stand. My leg would swell and hurt really bad. I never found out why it swelled and hurt so much. I just found that I needed a day in between working until finally I had to have restrictions in my day in order to work. Then lost my job because it couldn’t accommodate me. That was really painful, emotionally, because I worked my ass off even through the worst of my pain. I had no idea that it was so restrictive. But it was the only thing that I could think of so I wouldn’t have to take any more time off work and get off FMLA (family medical leave act). So I went from working two jobs to trying to work forty to none in four months. And it sucked! I really didn’t know what I was going to do. I tried to get another position in the hospital but little did I know the hospital had a hiring freeze on. I needed a job that I could work sedentary but couldn’t find one. Then when I lost access to my work email and such, I stopped looking and filed for disability. I already had two psych hospitalizations and was working on a third when I was out of work. I had to file for long term disability, which was a mountain of paperwork. I think it took more paper than social security! I got both within a month of each other. I was glad because finally I could pay off some bills that had piled up while I wasn’t collecting anything. But it still is tough living on a monthly check. I still have not learned the art of budget. I seem to pay the most important bills, my cell phone, Starbucks, health insurance, and cable bill. What I have left has to last me until the next month, which sometimes it doesn’t. I could have a dollar to my name until the next check. And I always make sure that I have transportation money or I am not going anywhere for the month. And that will suck!! I just got to figure out how to spread out at least two hundred dollars of spending money and make it last a month. And somewhere in there has to be food money. I can’t live on coffee alone.

the start of a connection

The start of a connection

I first met Michelle online through Facebook. I was struggling with writing and she kept posting how her writing was going every day. I asked her what the key to writing a book was and she said it was through writing something every day. I don’t remember how exactly she decided to take me on as a motivator for her writing projects, but I felt honored that someone thought that highly of me to do so.

It started off as a month project, then grew to another month and before we knew it, it was a year. We set up writing goals for ourselves, Michelle had them more than I did. If she completed her goal of writing for the month, she was rewarded with an article of clothing. For me, if I was successful with my blogging, I got a journal or added more funds to my Starbucks account.

Through this I noticed a change in my thinking. I was very depressed and suicidal when this writing project first began. I was also in a lot of physical pain due to my nerve injury. There were times I was prolific in my writing. Then there were days I couldn’t write to save my life. I would just write a page or two a day in my blog and that would be it. My blog became my online journal for the world to see and as it grew, the more viewers I had. It became an outlet for me to share my thoughts and pain and to help others. I also found that I was helping Michelle and that felt good. My suicidal thoughts peaked in February and I was wondering if I was going to be letting Michelle down with my death. I didn’t let her know, maybe I did, I don’t remember. And then through another connection, I found that I couldn’t let myself kill myself because there were people in my life that I cared too much about, Michelle being one of them. Slowly the thoughts decreased. I still have them today but they are not as plentiful as they once were.

My writing goals are still the same, though I have upped the ante a little bit by writing four pages a day for the book that I am writing. This seemed like an impossible goal but now I am seeing it as a way to express myself and to keep me here. And I thank Michelle for giving me the purpose she wants me to have.

Today is World Suicide prevention day and by the small step of human connection, though miles apart, it helps save one life today.

Michelle was kind enough to include me in her blog today. You can read it here.

my suicidal career (short version)

My suicidal career:

I write about this not in the sense that Ronald Maris created it as that would be a completed suicide and I am not dead. But my relationship with suicide is a long one, from the time I was eight up until now. It is a struggle I deal with on a constant basis. It along with my depression makes life very unlivable for me. I often think about death in so many ways. I plan my death in so many ways yet I am unable to act on it.

When I was younger, I had no problem acting on my impulses to kill myself. But then protective factors such as my niece and nephew entered my life and I couldn’t bring myself to go ahead and kill myself. The loss was too great for them. I couldn’t imagine what my sister would say to these young kids who adored me. They were my saving grace whenever I had a bad day and really wanted to end my life.

Then chronic pain entered my life and made the balance of protective factors seem out of reach. I felt that I had to ignore them in order to let myself get into the suicidal mind frame to end my life. And I got there several times in the last few years. I had one friend call me every single day for a week until the storm had passed. I had therapy with my therapist several times a week. Nothing stopped the pain and the hurting that I was feeling. And when the pain got worse, so did the suicidal feelings. The feelings turned into plans that never were executed. This is the story of how it evolved and how a few suicide attempts lead to more hospitalizations than I can count.

I first thought about killing myself at the age of eight. I don’t remember the particulars but I thought it would be a grand idea not to be alive anymore. This got worse when I was nine. I really thought that ending my life was the answer to my problems. I hated myself because I felt like I was a burden to my family. I felt I had let them down somehow. I started planning my death at my birthday that year because I couldn’t stand the pain of living anymore. But for some reason, the age ten had a significance for my family and my mother was throwing a big party. I don’t know why she was throwing the party and making a big deal out of it but I figured I might as well stick around and see what I got. I was disappointed that I didn’t get a tape recorder that I wanted. I didn’t try to kill myself that year. But I did try later that year when I had an argument with my mother that now I don’t even remember what we were fighting about. I just told her I wish I was dead and went to my room to try and kill myself. I placed a pillow case over my head and prayed for death to come take me away. It didn’t work. The pillow case was too breathable. I was left crying in my room what seemed like hours. I don’t recall if my mother ever checked on me. I hated my life from then on. Suicide was always on the back burner for me.

This is a book detailing my career in suicide and the journey I went on to deal with it. There have been a couple of close calls but nothing recent, though I still feel the need to kill myself at times. But I do not act on my thoughts. I have attempted suicide many times and according to all the statistics, I should be dead. The one study that I often am in awe at is the one where they found that suicide attempt reactions often predicted future suicide deaths. I am in that category of not wanting to live yet I am still here. I am the outlier. And I hate being the outlier.

This story is my life that centers around my suicidality and the works that helped me get through it. Without finding the American Association of Suicidology, the works of Edwin Shneidman and David Jobes, I doubt I would still be around to talk about my life in this way. There are concepts of these people that I hope to explain in layman’s terms so people know about them because they have had a deep impact on trying to keep me alive.

The first is Edwin Shneidman’s conception of the word psychache. It is a word used to describe psychological pain which is defined as the combination of hopelessness, despair, loneliness, guilt, worthlessness, unbearable anguish, intolerable pain, and helplessness one feels when in deep despair. It is the pain one feels that is deep within you when contemplating your life. His other concept, the twenty frustrated needs is another brilliant sign of what constitutes suicide. They are:
ABATEMENT The need to submit passively; to belittle oneself
ACHIEVEMENT To accomplish something difficult; to overcome
AFFILIATION To adhere to a friend or group; to affiliate
AGGRESSION To overcome opposition forcefully; fight, attack
AUTONOMY To be independent and free; to shake off restraint
COUNTERACTION To make up for loss by retrieving; get even
DEFENDANCE To vindicate the self against criticism or blame
DEFERENCE To admire and support, praise emulate a superior
DOMINANCE To control, influence, and direct others; dominate
EXHIBITION To excite, fascinate, amuse, entertain others
HARMAVOIDANCE To avoid pain, injury, illness, and death
INVIOLACY To protect the self and one’s psychological space
NURTURANCE To feed, help console, protect, nurture another
ORDER To achieve organization and order among things and ideas
PLAY To act for fun; to seek pleasure for its own sake
REJECTION To exclude, banish, jilt, or expel another person
SENTIENCE To seek sensuous, creature-comfort experience
SHAME-AVOIDANCE To avoid humiliation and embarrassment
SUCCORANCE To have one’s needs gratified; to be loved
UNDERSTANDING To know answers; to know the hows and whys

When you have frustrated needs your thoughts of suicide go up. One feels the need to be loved and nurtured and when that doesn’t happen a certain loneliness occurs and it is painful. According to Shneidman, one must rank these needs so the final sum of all is 100. I have never been able to rank them but I find that these needs are important in everyday life. He got them from another psychologist, Henry Murray in his famous book explorations in personality. The theory is that frustrated needs are a causal factor in suicide. Decrease the frustration and reduce the suicide. Then you have the ten commonalities of suicide (suicidal mind):
I. The common purpose of suicide is to seek a
solution.
II. The common goal of suicide is cessation of
consciousness.
III. The common stimulus in suicide is intolerable
psychological pain.
IV. The common stressor in suicide is frustrated
psychological needs.
V. The common emotion in suicide is
hopelessness-helplessness.
VI. The common cognitive state in suicide is
ambivalence.
VII. The common perceptual state in suicide is
constriction.
VIII. The common action in suicide is egression.
IX. The common interpersonal act in suicide is
communication of intention.
X. The common consistency in suicide is with
lifelong coping patterns.
Within suicide you have a vocabulary of suicidal terms. The list is exhaustive but I have a few favorites:

Hopelessness, psychache, lethality, perceived burdensomeness, thwarted belongingness, press, perturbation, fearlessness and competence.

Perceived burdensomeness, fearlessness, competence, and thwarted belongingness are not Shneidman’s term but of another suicidologist Tom Joiner. I read his book why people die by suicide and found it fascinating. It really is a good read and helped me to understand my suicidality a little better.

Hopelessness, the feeling of being lost in hope, that nothing is ever going to change, that things will always be the same no matter what.
Psychache is defined as despair, intolerable anguish, hopelessness, guilt, worthlessness, and unbearable psychological pain one feels. It is like pain in the heart that no one else can feel. Your heart feels heavy and you feel like a burden because of it. Nothing soothes this pain. No medication can touch it. And suicide seems like the only answer for this type of pain and anguish.
Lethality, the degree to which someone is at risk for suicide. Whether it be a loaded gun or a few bottle of pills or some cuts on the wrist. This is what determines how suicidal a person is and how they are going to act. If the risk is high and eminent, involuntary hospitalization is called for. If the risk is low, then more contact is need and assessment at every visit.
Perceived burdensomeness, the idea that you are a burden to those around you but in reality you are not,
Thwarted belongingness, the idea that you don’t belong anywhere and feel the need to belong somewhere. It is a very awkward and lonely place that hurts very badly. Everyone wants to feel like they belong somewhere or to something and when that need is not met, they feel detached and alone.
Press, similar to stress. It is as if the building of the press is similar to the pressure of a volcano ready to explode. It can lead to further perturbation and make things worse.
Perturbation, the need to feel or do something to ease the pressure and anguish and despair they are feeling and to feel better. It can lead to want to do something but the idea is that you need to do something to relieve the pressure of the feelings on your chest.
Fearlessness, the absence of fear. In this regard, it means that people may be fearless when trying to take their life, like a type of Russian roulette.
Competence, the meaning is the level of competence to carry out the means for their suicidal plan. Examples include rope for hanging, gun handling and shooting, knowledge of drugs, etc. High competency is a high risk factor.