it’s 2 am and I am still up

It’s 2 am and I am still up

Pain hit me bad around 2115 or so. My foot has been feeling like it is being crushed all day and still continues to feel this way despite my breakthrough med. But around 215, I started having severe suicidal ankle pain. This caused me so much fucking aggravation. Like the last nerve had been hit. I spoke the other day how I have all the ducks in a row and now they will call come together. I am sick of being and will be taking efforts soon to not be. It won’t be this week but sometime this month.

I am supposed to go to physical therapy in twelve hours. I am going to cancel the appointment mostly because my voice still isn’t there and I don’t want to be talking for 45 mins just for my throat to be sore the rest of the day. I will see if my voice is better next week and then have the eval then.

I sent a message to my psych to see when she wanted to talk, if she wanted to talk. I never got a response so I guess we aren’t talking. No big deal. I can try to talk to her on Tuesday. I sent her a thing she wanted me to write to try and get the therapist up to date on my suicidality. She hasn’t said anything about it so I guess it is ok. I wrote about the background and then how things are now. I also wrote about how I want her to be accountable to things we discuss and have them followed up the following week. I am tired of therapists not following through or continuing what was said the previous week. I have not printed this out. I don’t even want to see the therapist because I am afraid of what will happen. I told her some stuff about how I want to proceed in therapy from now on until the suicidality is somewhat under control. I am not sure how she will take this so I am nervous. I went through this with my long term therapist and things didn’t go well. She didn’t want to carry through on things and that frustrated me more than anything.

One of the things I talked about was the SSF (suicide status form). It is part of the Collaborating, Assessment, and Managing of Suicide (CAMS) framework. It is used to assess suicidality to get a better picture of what the episode it like for the patient. It is individualized for that patient and it really helps the clinician know where the problems or situations are that are leading to this person thinking about suicide. I have made copies of the forms from the 1st edition of the book but have not done so for the 2nd edition. The 2nd edition has the changes of a few things and on the current DSM (diagnostical system of mental disorders). The last message I had with the creator was a month or so ago and he was looking into an electronic form so that it could be easier sent to the medical record. The wonderful thing about the SSF is that it has all the documentation needed in just a few pages for the patient’s record. Right now that is just paper but eventually it will be electronic. I am not sure how that will go or if there will be a 3rd version of the book to reflect this or what. But it is in the works and last I heard would be ready sometime this year.

I don’t know if she would be interested in something she has not seen or heard of. The bottom line is that CBT and DBT (both of which she does) are also evidence based treatments for suicidality. I am not sure if this is true for chronic suicidality but I don’t think that has been studied.

1203 pm: I canceled my PT appointment. I didn’t sleep until after 0500 and with my voice being terrible, I really didn’t want to talk. Now I have the whole day to myself. It is nice out. I have one business I need to take care of before I go. I got to close my IRA account as I haven’t put any money in for years and because it is below the minimum amount, I have been charged every year, dwindling what was there. I figure I better close it before there is nothing and then be in the negative. The interest is not that great either. I just updated my book because I found it and it was only 1 to 2 cents given. I am just worried about how much taxes are going to be taken out because I am not of age to collect it. I went through this once before and it was a hassle. I think it was more because the bank didn’t want to do it than anything. Least that was my impression. Maybe I will go to the square and do it at the bank there as the one near me always gives me a fucking hassle with transactions.

I need to take a shower. I also need to change my bed sheets but that in itself is more tiring than taking a shower. My foot is a 7 right now. I know after the shower it will be up for a bit. Maybe in the afternoon I will go to do the bank business. I already had my coffee for the day so I won’t go to Starbucks. Though I might as someone misplaced or got rid of my reusable cup. I can’t find it anywhere. Maybe my nephew has it in his room. I will ask him when I see him.

Ducks in a row

Ducks in a row

I’ve been struggling all week. Pain and depression have been an all time mood sucker, increasing the suicidality to the point where the other night, I have things down pat. I am or should be “happy” about this but not really. The fact I can act at any time gives me some relief that when I want to escape, the choice is there. There really is nothing about what if anymore, well there is. I could be rescued or have a change of heart and get help before things take place. I won’t know until that moment. Worse case is I just get sick. I hope that doesn’t happen.

I had therapy this week. I still have no voice from my allergic reaction on the 16 Aug. I saw the folks in laryngology and the PA (physician assistant) said there is some constriction of the things surround the vocal cords, causing my voice to be the way it is. No cancer, polyps, or anything else causing this. I didn’t ask what was causing this as I just wanted to get the hell out of there. She was kind of freaking me out because when she started explaining things, she would shut her eyes and then go off tangent, making me all confused. My appointment was at 2 and even though I was in the room by like 215, I wasn’t seen till 245 and by the time I was done, it was 330. The camera was not pleasant. I had a microphone on my neck and it shifted. As she was trying to get it adjusted the damn fiber cable went further down my throat to the epiglottis, making me gag. I asked what can be done and she basically said time. I asked about speech therapy and she was not advocating for it so I practically had to beg to get referred to it. She said the therapy is booking out in a month’s time so theoretically, my voice could come back by then.

I was expecting this as the folks in the ED said the same thing (well more that I needed speech therapy, not so much it would get better on its own). My pcp pissed me off that day because he wanted me to stop my allergy meds. Even though I said I take it every day and have for years, they think it could be a reason. I really don’t see how all of a sudden this medication would make me hoarse. The laryngologist said the GERD could be causing this but I haven’t had too many episodes for this to happen and when it did happen before the allergic reaction, my voice didn’t change. She recommended some antacid that I am to take at night. It isn’t a kind that I can get at the drug store but online because it is supposedly made with seaweed. I don’t know. I don’t think that is the reason either, unless the ginger caused so much acid production it did affect my voice this bad.

I’ve been in contact with my psych. I spoke with her today. She asked what I was doing and I said I didn’t know as I just woke up and haven’t had coffee yet. She told me to get coffee. LOL She is too funny. Kind of strange that she only recently laughed at my humor and made jokes. Don’t get me wrong, I do love hearing her laugh. I just think it only took 26 years to hear it. LOL She didn’t tell me when she was going to be in an office soon. I haven’t asked because I know she will tell me when she has one. She does want me to write to the therapist about the stuff that is going on. Think I will do that today. I really struggled to talk to the therapist this week because of my voice. It was so shot after seeing her Wed. But then I was up more than 24 hours when I saw her. I was also up most of the day Wed. I just could not sleep despite taking melatonin and Ativan. I was so overtired. I felt like total shit yesterday and still feel crappy today, though much less so. I did a few errands today and my last stop had me weary. By the time I got home about 15 minutes later, my ankle flared up (it was already a 9 to begin with) and I just felt weak. I got some stuff to do in my room (there always is stuff to do in my room). My sister has once again become a tyrant. She said she was going to do stuff this week to clear my room and bring some stuff up. Has not done so but I am guessing tomorrow she will. I hoping she won’t. She is really sending my anxiety up the roof and I have been so hypervigilant that it is hard for me to relax. Yesterday I wanted to sleep but I kept thinking (even though she wasn’t home) that she was going to barge in my room at any second. If I can do two things that will make things easier for access to my alcove, I am going to try. Wish my nephew didn’t move all the stuff to block it even more. Now I got to move it all to the other side of the room where there isn’t much room to begin with. Just overwhelms me to the Nth degree.

feeling shaky

Feeling shaky

I had a few hours sleep. I had another bad night of pain that kept me up. Around 2 I started writing a letter/email to my psych. I told her how frustrated I was with her being dismissed and my anger about the institution. I also told her how difficult it is to call her when I am suicidal and thinking about acting. I had emailed her to find out when I should call her. She always said to call her but I didn’t know when it would be okay to do so. I always feel like when I call her, it should be an emergency as I usually just email her. I only call if my anxiety is through the roof and I can’t calm down or I am in overwhelm mode and need her to help calm me down. I haven’t had a response to the email, yet. I am not sure I will but we will see.

When I got up, I had one coffee, a cold brew. I had to go to the grocery store and the pharmacy to pick up my meds. I did a little shopping and got my favorite ice cream. I was worried it would be soup by the time I came home as it is really hot today. Tomorrow is going to worse. I hate summer. I went home quickly and luckily I didn’t have to wait long for the bus. I was starting to feel shaky when I came home, like I had three cups of coffee or something. I still am feeling jittery, even after I ate and had a soda. I just took some pain meds and my urine retention meds as I haven’t used the bathroom since I got up. I hate that my bladder isn’t working right. I see the urologist next week to find out what is wrong, though I suspect it is the nerve damage that I have. I don’t know if I will have to self cath or not. I hope not. I don’t know if the med I am on needs to be increased or just switched to another one. I did have success with Flomax when I was in the hospital for my second surgery. It really helped with the retention but didn’t always work after the re-do surgery as I was retaining. I remember when I had the MRI I was completely gone. My mental status was out in left field. I was being catharized and it was like I knew where I was but I didn’t. I thought I was in the ER but I was on the floor of the hospital. Least I knew I was in the hospital.

I have therapy tomorrow and I will discuss my past abuse which is going to be really difficult as I am having PTSD symptoms that are really bothering me. I had a medical procedure when I was little and I keep having intrusive memories about it. I don’t know what kind of test they were doing. I just know I was screaming for my mother and they had to restrain me as I was fighting them severely. I was totally freaking out. They had to sedate and anesthetize me. I was so distraught. Then I felt like my mother abandoned me and I was really angry at her. But I couldn’t tell her I was mad at her. I was a kid and you just didn’t say that to your mother. I have no idea if this created the voices. I was talking to them the whole time I was up and my thoughts were really fucked up. I had to take another antipsychotic to quiet them down. They were still quiet this morning and I had a hard time thinking. When they are quiet I find it hard to function. I need the “background noise” as I feel empty when they aren’t there. I also feel alone. They have been with me since I was five.

I am not really feeling anxious. It is more like agitation. I want to keep moving but don’t feel like it. I am really restless. I wanted to write to see if I could calm down as that sometimes works. Last night I wrote like three pages in my journal and it didn’t help. I just got more keyed up.

I really, really hate when you tell someone you are hearing voices and their immediate response is to tell them to shut up, like that fucking works. It irritates me so much. Like don’t you think I have tried that? Fuck. People have no clue what I go through or really anyone who have hallucinations, whether they hear or see them. I really don’t know what the “right” response would be but I know it isn’t “tell them to shut up.”

I think I am having side effects of the trilafon I took last night to quiet the voices. It feels similar to what I have experienced when I was on abilify. I probably need to take an Ativan to shake off the side effects. Living with this shit is so fucking hard. I am so tired of side effect of my medications. I know the risks outweigh the benefits but dammit, I hate the shakiness. I hate the constipation. I hate the brain fog and cognitive impairment.

random psych shit and things

Random psych shit and things

I had three hours sleep last night. I didn’t go to bed till 0730, woke up at 0930 and then again at 1030. I had to really get up at that hour because I had to be out of the house by the latest 1105 to catch the bus. Course I go downstairs, hoping to shave and my mother is in the bathroom wanting to wash up. Figures. I tell her I need to wash up and she says she will do so fast. She is never “fast.” I waited for her to get out. By that time it was around 1045 and I just brushed my teeth and got the eye crud out of my eyes by washing them. I couldn’t be bothered with the rest of my face. It would have to wait.

I had time to fiddle after using the bathroom, but not much. I got my clothes on before sitting on my bed. I tried to find a belt I could use for the pair of shorts I found in my drawer. They are a size 38, which after all the weight loss, I fit into again. I didn’t need to buy another pair of shorts as the size 42 is way too big on me. Not eating is not how I wanted to lose the weight but it happened so there isn’t much I can do except to keep it off, which I have and knew I would. I might have gained and lost the same three pounds the past few weeks but then I will drop 8 lbs the following week so I guess it evens out eventually.

I went to Starbucks and had my espresso. I had a new barista. I asked him for soy and all the baristas that I ever had have given me the container or a quart of it. This one pours a tall cup and hands it to me. WTF. I don’t care, I just want my fucking espresso. He was cheap with the ice so I just said fuck it. He looked to be a smartass anyway and I wasn’t in the mood to argue. I totally got my time messed up because around noon, I left for the station. It wasn’t until I was halfway to where I needed to be, I realized my appointment was at 1345. I was more than an hour early. Goddamn it. I went to the lobby of the building and just wrote in my journal. Then I washed out my reuseable cup and went upstairs. The therapist took me early. I was beyond tired by that point and wasn’t too chatty though I did try to have a conversation. The therapist kept on looking at her computer screen and then looked at me so fast I thought she was going to get whiplash. No idea what she was looking at. Somehow she asked me if I was in crisis or something and I said I don’t know, not right now. Could change in 24 hours, which it could. She said that wasn’t reassuring. Then she said “we need to monitor how you are and such.” I am thinking ok. Next thing I know she is telling me she is off next week and she will see me in two weeks. WTF seriously?? She didn’t offer a safety plan or who I was to call if I needed to talk to someone while she was away, nothing! I got pissed off. Because she took me early meant I would be home on time for my psych to call me.

I had just missed the bus when I got back to the Square. I had to wait a half hour for the next one. I just listened to my music. I tried to read Twitter but my eyes couldn’t focus and it was really difficult as the sunglasses I was wearing weren’t prescription. I have either thrown them out or they are somewhere hidden in my room. I won’t know until I try to find something else. Like today I was trying to find the key to my cash box and found my class ring instead. I thought I had lost it for good while I was working in the lab. I could have sworn it was in my lab coat that got thrown away. I am glad I was wrong. That made my day until my psych called me. We talked and then she said she had a question for me, would I be okay to see a psychiatrist they had assigned me. That psychiatrist contacted her and wanted her input before they contacted me. I then asked her ok until she sets up shop somewhere and when that would be. She said sometime in the fall. She then asked if I was okay with meds. I said I have one refill left on all of them so would be set for the next month, month and a half. And if I couldn’t see the guy, I would call her. I told her about the dissociation part of Monday/Tuesday night where I somehow scratched my wrist. There were a few marks. I have no idea what time it was, what it was with, or why I did it. I don’t even remember doing it. She said if it happened again to call her right away. My immediate thought was that could be a while as it took me all day to realize this when I emailed her around 2200 Tuesday night while waiting for the last survey for the study I am in to come through. I was going to sleep afterwards and I did until like 9 or 10 am. My psych said she would call me either tomorrow or Monday to let me know what the new guy said and what his availability is.

After the phone call, my heart dropped. I was completely hurting and heartbroken and angry. I almost had a meltdown but somehow prevented me from uncontrollable sobbing. Fall seems like forever right now even though, technically, it is only a few months away. She didn’t tell me where she would be. I didn’t ask. I was too stunned to know I was actually going to see a new psychiatrist after twenty-six years, least for a little while. She still wants me to keep her posted and stuff. I don’t think that will ever change. I’ve always have, even when she was away on vacation or out of the office or on medical leave. This week has been a blur and today just sucked totally. Once I knew I wasn’t going to fall apart, I made myself a cheeseburger, which my stomach is still not happy about, even though I liked it. It was really good. After I ate, I shaved my head and face. I got rid of the mustache as it was all uneven and hairs were longer in places than others. I looked in the mirror afterwards and I looked like I was 12. I sent the pic to my psych saying I was indeed 12, LOL. My face has slimmed up and with the facial hair gone, you can really see it. Losing around 25 pounds helps. I still can’t believe I lost that much weight in such a short period. My waist shows it though. I am not 100% sure it is the T giving me the loss of weight or the loss of appetite/not eating due to pain, or the combo. We may never know. All I hear is that people gain weight with T. I might be the exception.

Now I just wait for a stranger to call me or his secretary to schedule an appointment. Not sure if my psych is still wanting to keep tabs on me now or if she just wants me to keep her posted on things. I guess I will find out when she calls me.