Ok maybe a little blogging

Been doing a fair amount of walking today, which wasn’t my intention. I tried to nap but noise kept me up every time I thought I was going to doze off. Foot/ankle are all swelled up and hurt like fucking hell. Pain is easy a 12 right now. Feeling so fucking suicidal. Bones are just aching and feeling crushed. It is always the trigger. One day it is going to set off the gun and swear once it is in motion, I am not going to stop. Be foolish to. I can’t take pain getting worse or my back being a time bomb. It is always half my goddamn foot/ankle. Going to be a long night. Glad I took my pain meds early, though might need another one in a few hours. Hate taking pills all the fucking time for this.

I got the start of PT next week but with my voice being shot, I don’t think I will go. I will just get a referral when I can speak without it hurting so bad afterwards. I am supposed to go back to laryngology in 3 months. The PA said I can cancel if I am “better”. Honestly the woman is whacked. Should send her a message and see if she knows why the whatever it is is making it hard to speak. I never asked her that.

Temps are supposed to drop tomorrow so I am going to be hurting. Temp went up to fricken 80 today. I thought we were done with hot temps. But that is Boston for you.

Mood has been awful today. Just feel so hopeless and with pain hitting me at night, just makes it worse. Really don’t see how this is going to change. Was supposed to have therapy tomorrow but I canceled. Too painful to talk. Never thought I’d lose my voice in so many ways. First is writing and second is literally. Guess my psych is not going to see that book published.

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.

frustrated on so many levels

Frustrated on so many levels

I saw the therapist today. I was really nervous about it because I didn’t have a voice. First part was of her reading all that transpired since I last saw her, which was last Monday. In there, I had mentioned I was suicidal and she asked if I was safe. I hate that fucking word when it comes with being suicidal. I never know if I am truly safe. If it was put in the how likely am I going to act or something, the answer might be a little different. Each time I get the urges, the situation is different so I have different levels of coping with it. It might be some grounding, music, distraction, going through social media and getting support there, or just maybe sitting with whatever I am feeling to get through the moment. I have recently just stared at a wall while letting the feelings hit me, one after the other and I try not to think in those moments, which is hard to do. Some times I can write but lately I seemed to have lost my words (mostly due to being reported on my feelings) that I cannot express myself, not even in my journal. The words are there, I just can’t seem to put them in cohesive sentences. This is the MOST frustrating thing because writing used to be my escape and because of vigilantes, my escape has been hindered.

I left aggravated and angry. I was looking for her to offer something to appease the suicidologist in me but nothing was forthcoming. I don’t know if she was looking for me to have some sort of plan (I have many, some good and some not so good) or what. Her biggest thing was for me to be “safe” whatever that meant. While I was home reflecting on this, I basically realized I have four choices: 1) go to ED of some sort; 2) call my psych, no matter what hour as I most likely will be in real danger at this point; 3) stew with the feelings as mentioned above; 4) act on my feelings/thoughts/urges. I have a straight forward plan so as long as I can walk (presuming physical pain isn’t the driver of the suicidal escape), the plan can be executed with no one much the wiser.

The ONE thing no one understands about suicidality is the need to escape from the pain (physical and mental or either/or in my case). It is also true that if I have an angry row with a family member that has me feeling unworthy, useless, lazy, etc., my thoughts of escape increase because I feelings of being trapped are heighted and I will think of suicide as my only choice in the matter. I honestly have no way of conveying this and having a “treatment” for it. Yes, I can bring up CAMS (my preferred way of dealing with my suicidal feelings) but my therapist doesn’t even know what the fuck it is, and from the sound of it, is not up to the latest suicide prevention stuff. Honestly, I don’t know who is as there is a LOT of information out there.

The therapist also wondering if being that the institution I was at was good for me as I have so much anger at it right now as it got rid of my psych. I think part of this is mostly likely the grief of her not being there and right now I am in the anger stage of that grief. The frustrating fucking thing right now is that because of my voice being fucked up, crying hurts so I am unable to process it with a good cry. Even as I am typing this and letting some tears out my throat is starting to hurt in a big way. I think once I have this cry, I can possibly moved on. My psych is still there for me; she hasn’t left. I just haven’t been able to see her as she doesn’t have a new home yet. I am still her patient because she has said so and I believe her. If anything, I think she fears me leaving her more than I fear her leaving me. If that makes sense.

I am utterly exhausted right now, mentally and physically. My throat is fatigues and hurts from the twenty minutes or so that I spent talking to the therapist. I honestly don’t want to talk to anyone, unless it is in written form, for the rest of the day. The only thing I have eaten today is a donut and a coffee cake. That seems to be the only thing I want today. I may have the last breakfast burrito (if there is one) that is in the freezer later but chances of that happening are low. I might have to make some more tomorrow after my groceries are delivered. It is nice to have some pre-made food that I like that I can zap in the microwave for a few minutes and have a meal.

I don’t have any plans for tonight. I might read Harry Potter or just be on social media. I would like a nap but that has yet to happen. I just seem to lay down and my pain decides to act up. My foot is already acting up with the ceiling fan going. Airwaves are annoying it. I really shouldn’t have listened to the meditation thing the therapist had me listen to. It started off by thinking of the feet and how they feel and such. Both feet were killing me so it was hard to “let go” of the feelings and shit. Then that was the only thing I could focus on. When they moved up to the abdomen I started feeling hypervigilant of someone barging through the door and had to stop it. At least we tried it. I knew it wasn’t going to work as I have done similar shit while inpatient and it is always a trigger for me.

I had written in the notes I wrote for the therapist to update her that I was thinking of getting ginger gummies and just sitting somewhere to eat them. By the time I came home, the plan was set. I figured out the location and all the how, what, when, where, and why. I have the four choices listed above on which one to choose when those urges arise. I will be left to my own devices and the choice really is mine to make. No one can stop me, no one needs to know, and no one will be there when the decision will be made. I am on a precipice. Question is, do I have a hand (figuratively) to hold me back…

I’ve decided that I won’t tell anyone about my suicidal thoughts. Might mention them here but just the thoughts. No one seems to want to hear them anyway.