Drugs

Generally the problem drug on the wards is cannabis (bud if you want to be hip). There are always a group of young men and one or two women suffering from drug induced psychosis ,basically schizophrenia, from smoking too much weed. And it has a tendency to find its way onto the wards. This time though it was coke. 4 men clubbed together every night to get their next fix which was duly delivered o the hospital by the dealer.

But one night it went badly wrong. The retrospective view was that it wasn’t coke but ketamine or crushed up amphetamine. One of the 4 went very badly paranoid and set out to murder one of the others. He wrecked the ward and was punching through glass designed not to be punch through.In  the end it took 17 police officers with riot shields and a police dog to corner him. The next day he was shipped off to a secure unit in London.The other 3 have sworn off drugs but we shall see.

Freedom at last

After 12 weeks, 2 days I am finally free. And a bit overwhelmed by that freedom. It takes time to adjust to normal life. The hospital I was in wasn’t too bad – at least you had your own bedroom and shower. In my early days in the system it was long dormetries and fairly disgusting shared baths.

I went in voluntarily which given my subsequent treatment was a bit of a misnomer. Everytime I tried to leave I was told I would be sectioned. I had very restrictedm escorted leave. At one stage I was put on an one to one, whereby you have a nurse following you everyone. One time I escaped and when they caught up with me I was on the street. Now according to the law they can’t touch you once you are off hospital grounds. But that didn’t stop them dragging me back whilst all the time I was complaining loudly with it all falling on deaf ears. The best though was when I got out the door and about 4 staff pinned me to the ground. Now that is a definite no no. In reality the only difference between being informal and being sectioned was that if you are sectioned you have a right of appeal to the Mental Health Tribunial.

It wasn’t all negative.The staff were inthe main, very supportive. I got on particularly with two of them who very patiently listened to all my outpourings.

That’s it for the time being but there is lots more to come.

Hospital

Still incacereatted

absence

Apologies for my absence but I am currently a guest of nhs. Normal srevice will be resumed in the next few weeks.

A boring week

The most adept description for this week is ‘boring’. I have tried hard to activate the patients but they all want to stay in bed. Bed is far more interesting than a trip to the cinema. I couldn’t even get anyone outside for a breathe of the spring air. When I suggested it the patients in the smoke room looked at me as if I was mad.

Today I got stuck between two women each talking their own delusions and in fact quite content in those delusions. I lasted an hour and a half, made my escape and was immediately corned by someone else. It can be quite draining listening and sorting out delusion from non-delusion and being able to make the appropriate responses.

Later on I took 2 clients to the local shopping centre. For one of them it only his 3rd time out in 16 months. He started getting wobbly so we beat a hasty retreat back to the hospital.

I left the house this morning to find a dead, headless bird on the grass and a pile of feather encrusted vomit on the path. I left it in the hope that it might have disappeared whilst I was out. Sadly it was still there on my return. Cat denies all responsibility. God knows where the head is. If I still had my old keyworker I would have phoned him to come and remove it but i haven’t seen my new keyworker for a long, long time and so haven’t built up a relationship that could encompass bird corpses.

I saw the psychologist again this week. She keeps insisting on telling me how well I am doing. This is very dangerous – praise comes before a fall. We are currently discussing emotions and in particular anger. Neither figure in the top ten of my favourite topics. To make things worse she keeps giving me homework, getting me to write on various topics. One bottle of wine later and I might get something on paper.

The consultant’s sidekick came round this afternoon to lecture me on my lifestyle. I did waonder what was up when he said yesterday that he would visit. He is such a lovely man that it is just not possible to disagree with him. He went on all fronts – eating(or lack of it), exercise (ditto), wine (too much of) and I need to find something to do in the evenings. If he has his way I will have cracked the diabetes by the summer – watch this space.

When I got my repeat prescription for my phfsiacl meds i was given a leaflet with the diabetic tablets. It flags up a warning to be careful with my antidepressant and the antibiotic the GP has prescribed for 3 months. I figure that no harm has befallen me yet so I should be alright.

My mother – family beware

My mother was a complex woman and I had a difficult relationship with her. She didn’t know what was going on with me as a teenager and I was so self centred I didn’t have the interest in why she was as she was. That came later with therapy.

She phoned me one Saturday morning at 7.30 to say she didn’t feel well, could I come over and don’t tell anyone else. The last instruction was a bit tricky because I happened to have my sister and nephew staying and couldn’t really disappear without telling them where I was going. So the 3 of us made our way over and when we were there tried to convince ourselves that she had a virus. I called the doctor as soon as the surgery opened. The doctor came out and diagnosed a stroke.The rest of the ‘ill’ history is included in a previous post. This post (and hence ‘family beware’) is about her death.

About 3 weeks before my mother died she was struggling to eat and drink. The nurses in the home told me she had given up and I kept saying that I didn’t think she could swallow. They weren’t the slighest  bit interested in what I had to say and I sort of took the view that they knew best.However my sister was up one weekend and we cornered one of the staff and insisted she got the doctor to see her on the monday.

Not knowing what time the doctor would come and see her, and not trusting the staff, I got there by 8.00am.I found my mother slumped in a chair and barely conscious. I asked the staff to put her to bed but they said they couldn’t until the doctor had been. ‘ what time will that be?’. ‘we don’t know’. About an hour later they came and lay her on her bed. Another hour went by and they came and put her to bed. Went I got there they asked me if I could wipe her mouth out regularly with a glycerine swab. And then a large cotton wool bud soaked in water. She would bite on that as if to get the moisture to her throat. I guess that i knew she was dying but was waiting for confirmation from the doctor.

He evntually turned up in the afternoon and I will never forget the look of horror on his face when he saw my mother. He did the ‘drinking test’ on her and said she had  had another stroke and couldn’t swallow. A phyricc victory.

The doctor said that we needed to talk and I replied’tube feeding and drips?’ Whilst Iwas sure what the right decion was it was a lonely one to make. About a year previously I had asked my mother if she would want to be revived if needed and she said a very emphatic ‘no’. This combined with her telling me in the street that she had had enough was sufficient for me to be confident in my decision.

The doctor said he would put her on morphine ( I had the impression that he thought that should have happened a few days previously). He said that she was starving and dehydrating to death and the morphine would ease the way.

In between trying to find the Priest to conduct last rites I phoned around the family. The doctor had said that she would last 3-5 days and so everybody said they would be there later in the week. I think my brother’s wife put pressure on him because he phoned again to say he would be up the next day.

The Priest eventually turned up at midnight. Although brought up as a Catholic I am not a particularly religious person. My mother smiler as he came in – the last person she was to recognise.After the Last Rites were said the whole atmosphere in the room changed. It somehow became lighte.

My brother arrived at lunchtime the next day but didn’t come to the nursing home. I needed to get back here , firstly to cancel the holiday that I was supposed to be going on that day and secondly to pick my aunt up from the airport. I thought I left her in the capable hands of my brother but he wasn’t there when she died. I guess he had his own issues.

Therapy

At one time I felt like I had seen most of the therapists in the region. I don’t take to therapy easily - I could win awards for my shoulder shrugging abilities. Having said that there were one or two particularly dire ones. One in particular insisted on coming to the house which i didn’t appreciate. Anytime I opened my mouth to say the most innocuos of things she would exclaim ‘how dreadful’. She lasted 3 sessions. Eventually I struck lucky – there is nothing like perseverence. I was referred to someone new to the Trust and went along feeling desperately sceptical.By the end of the session I thought that perhaps this was someone I could work with. You don’t have to like your therapist but you need to respect them. I did both in this instance. It helped that all along I had a very good consulatant psychiatrist who was gradually chipping away at my defences. I saw this therapist for about 18 months and then to my great disappointment she moved away from the Trust.

After that I saw one who was going to help me with depersonalisation only I quickly established that she didn’t know anything about it. So I sacked her. After that I saw someone else who did her very best to demonise my mother. Now I have had problems with my mother but I wanted to understand not condemn. After about 5 sessionsI realised that I knew far more about her and her family than she could ever hope to know about mine.So she was discarded.

And then the good psychologist came back to the Trust for a year and i was re-referred to her. it turned out that the time lapse had been quite helpful as had been the dud therapists. It made me appreciate what was on offer. Don’t let anyone ever tell you that therapy is seasy. Give me tablets any day. I was seeing her twice a week and my consultant once. In some ways I felt that psychology and psychiatry were taking over my life.Having said that my mother had had a serious stroke by this stage and both were enormously supportive. The psychologist sought to find reasons for the ‘issues’ I had with my mother. To understand and not to criticise.

And then she left again and it was a long while before I was referred to anyone else.I can’t quite recall why I was referred but referred I was. This time it is very different. The psychologist comes to the house with a nurse . I thought I wouldn’t like this but it has worked out ok.The therapy I ‘did’ before was psycho dynamic. I am now dabbling in cognitive behavioural therapy (CBT).It is not, as it were, strict CBT – there are no mood diaries and we periodically delve into the past. The focus is on anger and guilt as a key to depersonalisation but I fear that that might be too simplistic.

Nutty friends

When I worked my friends were lawyers. Now Iam in the mental health system most of them are nutty. I guess it takes one nut to know another. It can be very draining – the demands are in someways much greater than in ‘normal’ friendships.About 18 months ago nf1 would phone me on a nightly basis threatening to throw herself into the reservoir or electrocute herself in the bath. The reservoir threat was not an idle one – she is known in the system as ‘The lady of the lake’ because of her midnight swims. At the same time another friend was very low and I spent a lot of time talking to her. At one stage I felt that I was running a telephone counselling service.I ended up in hospital due at least in part to the stresses. But they carried on phoning whilst i was there. And visiting.

About a year ago nf1 found a dog. Literally – she came across him in the street, decided he was stray and adopted him. Since then her life has turned round. She is now so obsessed with the animal she has no time to think of herself. Her only visits to the reservoir are to walk Tigger. In any event she is no longer talking to me. She fell out with nf3, who was a longstanding friend, over a box of cigarettes. When I carried on talking to nf3 she decided that I was being disloyal. I thought I had left all this sort of thing behind when i gave up law.

Nf2 is currently in a bad way. In fact she has been bad for months and nothing seems to pull her out of it. She is 1 of 19 children, a sizable proportion of who suffer from either bipolar or schizophrenia. Her mother committed suicide as did 2 of her siblings – one 2 years ago today. Her genes are very much against her. There is nothing much i can do save phone her everyday and make sure she has food in the house. They are just about to start her on another antidepressant but she is not holding her breath.

As a digression I worked out today that I take 26 pills a day – 14 different medication spread out 7 times in the day/evening. I recently went to the GP feeling fairly fit and came out with a diagnosis of diabetes, high cholestrol, low folic acid and various other things. It all amounted to a sheaf of scripts. At least I don’t have to pay for my prescriptions.

Owing to the leak yesterday I had to empty a cupboard in the backroom because that is where the loft hatch has conveniently been placed. I discovered a whole rail of work clothes – skirts and jackets – can’t remember the last time I wore a skirt. And then there was my robe for court. It was all quite poignant as I dumped them in a black bag to take to the local charity shop.

I had my car serviced and MOTed today. Always a nerve racking experience. The good news was that it past. The inevitable bad news was that it will need 2 new tires and a complete exhaust system within the next few months. At least it gives me time to start saving. I need to find a few more committees to sit on.

Back to the Asylum

I went to a meeting this morning. It was boring to the point of complete tedium. I have been co-opted onto a committee by someone who asked so nicely that I couldn’t respectably refuse. I loathe meetings and feel that perhaps I should have been a tad more assertive when asked. When someone talks at lenght never mind how hard I try not to I always seem to end up complying a mental shopping list.Today’s was for at least a month. The upside of it is that I get paid £15 which funds a night in the pub. I was thinking that maybe there is a career to be made out of attending meetings. If I fitted in 2 a day that would be £130 pounds which is more than i get on benefit. However i don’t really think that i am that self destructive.

There are some more than usual potty people on the ward at the moment. J is an elderly lady of 72 who shouldn’t really been there except they have just closed down one of the main elderly mentally ill units. Apparently she starts talking from the moment she gets up until she goes to sleep. For all I know she probably talks in her sleep. If you talk to her she chats back and very witty she is. The rest of the time she talks to herself. There is not even a voice to talk back to her.I think they are keeping her in hospital until they win the argument about her going into sheltered accomadation. The danger is that she gets well settled into hospital and doesn’t want to go anywhere. That happened with another elderly patient who ended up being there for well over a year. They were so concerned about how she would react when they tried to move her that they had the police on site.As it happened she walked out smiling.

V. is quite a regular patient. This time when she was admitted she was literally skin and bone. She was drinking so mush water that they had to locker her bathroom and the 2 main toilets downstairs. She goes around with a plastic bag on her head because, I think, she had a morbid fear of headlice. She used to frequent the pub across the road but has recently been barrred. No one is quite sure of the reason.

I took a patient from the men’s ward and one from the women’s shopping this afternoon. As soon as we got into the shop they both raced off in different directions. They are both on Sections and there is a small risk of abscionsion. I decided to stick with P because he was very nervous. He has been in hospital for well over a year and this was only his third exursion out and I was aware that he might find it difficult. But when I went to look for D there was no sign of her. P got very upset and wouldn’t buy anything until we tracked her down. I was initially pretty laid back and then he started to get me wondering. I eventually discovered her deep in the tracksuit section.

A minor digression: I came home yesterday to find water dripping through the ceiling. I sat and looked at it for a while and then it crossed my mind that perhaps i should be doing something. Coincidentally I had been talking to my bank last week and they mentioned in passing that i had also sorts of domestic cover. I eventually managed to track down the booklet and yes, lo and behold, I was covered. There was a lapse of 1hr 30 between me phoning and the plumber fixing the problem. Cat is a bit distraught becasue he had only recenlty discovered the airing cupboard as place to nestle into. Now it’s all soaking wet and so he is back on my bed.

An excursion into hospitals and nursing homes

Early one saturday morning a few years ago my mother phoned me up. She said that she didn’t feel well and could I go over. Oh, and please don’t tell anyone else in the family. This was a tad tricky because my sister and nephew were staying and I couldn’t exactly disappear without telling them where I was going. The phonecall was without precedence so we knew there was something potentially serious wrong.

When we got there she was still in bed. In fact couldn’t move out of bed without support. I called the Gp, my sister sat weeping and my nephew made a fruit salad. The GP came and said he hought she had had a slight stroke. Slight? She didn’t want to go by ambulance to hospital but I pointed out she wouldn’t fit into my mini. So by ambulance she went. I went along for the trip and my sister followed behind having entrusted my nephew with my mother’s neighbour. (incidentally the neighbours had phoned the duty doctor the previous night only to be told that old people fall over all the time. I duly made a complaint.). My mother spent the whole journey of about 10 miles talking to the ambulance person about the poor terms and conditions for paramedics.

She spent the weekend in a sort of ‘holding ward’ where a stroke was diagnosed but it was more serious than first thought. Over the space of the weekend she lost the use of her left side. On the Monday she was transferred to the geriatic ward. This was a hell hole. I can think of no better description. it was run down, tatty with totally disinterested staff and people dying with little dignity left right and centre. Simple things: at breakfast they would give her a cup of orange juice with a tin foil lid and toast with the butter seperately. Try buttering toast one handed. At lunch they would dump a meal  in front of her with no effort to cut it up. She was supposed to drink alot of water but more often then not there was no water. If there was water there was no cup. I could go on and on.

When my mother had ’settled’ she was transferred to the stroke rehab ward. Quite what the rehab was I never made out. At this stage I was still visiting 5 times a week (a 2 and a half round jorney) and was getting increasingly disillusioned about the NHS provision for elderly people. They could at least have got some staff who cared.Everyone met up for Christmas which was almost unheard of in my family. On Christmas day my mother said she didn’t feel well and wouldn’t get up. They accused her of being anti social but eventually called a dr who diagnosed a pulmonary embolism. So it was back to the first hospital and the first ward. From where she refused to budge. As far as she was concerned the only place she was going was the cottage hospital in her home town. They kept telling her there weren’t the appropriate facilities there. Needless to say she got her own way.

So she moved to this old Victorian 3 roomed, slightly shabby hospital and had the time of her life. She used to sit there in the conservatory holding court. In the end they banned visitors for two hours in the afternoon so she could have a rest.

And then from there she moved to a specialist stroke rehab unit where she was by far the eldest. Initially they were very keen on her and she had intensive physio. It was like a little community where everyone mixed together in the evening. And then she started getting confused so they decided (without any medical evidence) that she had got dementia and they couldn’t have got rid of her fast enough. It turned out that she had a bladder infection which can cause similar symptoms.By this stage my sister and I had been looking at nursing homes and put her down for the waiting list for 2 of the less grotty – basically the poshest. I went to a careplan meeting with my brother in which they made it clear that they wanted shot of her. I don’t suppose she was going to do much for her stastics.

And so she moved to a nursing home. There was one stage when she started getting confused again and I asked for an opinion from a geriatic psychiatrist. Possibly more for my sake then hers. His opinion was that there was no way she has dementia. She told me on the monday that a strange person had come to see her and asked her lots of silly questions.

There were 2 problems about this nursing home : 1.it was in the middle of nowhere and 2. there was nothing to do. My mother knew (but I thought she was deluded) that there was a new home being built in her home town and she wanted to go there. I went over to have a look and it seemed perfect – bang smack in the middle of town, a very caring manager with lots of good ideas. But sadly it didn’t work out quite like that. Save for the very loyal, her friends had abandoned her. The nursing home was distinctly iffy. They too decided she had dementia and put her in nappies rather than taking her to the loo. She became more and more depreseed and disillusioned. I used to go over 4 times a week but by the end she was sending me away after 5 minutes. (a 2 hour journey for 5 minutes). At one stage I got a care assistant sacked because another care assistant told me she was mistreating her. It is always a good idea to know the bottom rung not least because they do the most, they are always likely to be the most honest.

I took her for a wheel around town a few weeks before she died. And she said to me ‘I have had enough’. And I said ‘I know, but I can’t do anything’,And she said ‘Can’t you?’ That freaked me out a bit.

Enough for now.