Incredibly Weak Quadriceps

I’ve been struggling with knee pain and difficulty (sometimes downright impossibility) with any activities that involve putting weight on my knee while also bending it.  I can’t squat to watch my guinea pig munch on his lettuce anymore, which is possibly the cutest thing ever.  I can sometimes barely make it up and down stairs and my legs shake when I do.  A couple of times recently I’ve been faced with steep slopes and not even dared to try.

At my physical last month, my doctor told me to avoid long walks, ice my knee 2-3 times per day, and start taking diclofenac, a pain medication that she prescribed.  She scheduled me to follow up a month later, at which point I had run out of the medication and noticed a definite spike in the pain again.

I had my doctor appointment Tuesday and on Wednesday I was at the hospital starting physical therapy.  I’m falling apart so badly that the physical therapist, Alice, put me back together with kinesio tape.  After the assessment she commented that I have “incredibly weak quadriceps” which was allowing my knee caps to shift slightly to one side and rub the other bones.  Ouch.

I learned the six exercises that she started me out with, and scheduled another appointment for today.  Both Wednesday and Thursday I stared at the papers of exercise instructions, hoping that I was doing them right.  Each exercise has 3 sets of 10 reps, for each leg.  As I counted, it went like this on each set: “One, two, three, four, five, six, this sucks, this sucks, this sucks, this sucks.”  This is definitely a “things will get worse before they get better” type of situation.

At today’s appointment, Alice had me start out doing six minutes on a cross trainer.  It stung a little when around minute four she checked in on how I was doing, I mentioned getting a little tired, and she said, “That’s because you don’t like to do anything.”  I know she didn’t intend to be mean, but I almost got defensive – of course I don’t like to do anything, because it hurts and I’m scared I’m going to fall!

Next up were some exercises with parallel bars for support and a small step that is much shorter than those in a set of stairs.  Then I was back on a table doing one set of each exercise she taught me on Wednesday and having her correct my form.  Then it was over.  20 minutes.  She asked if I wanted to ice my knee while I was there, and it hurt a little, but I said I’d be okay until I got home.

I asked for advice about going to the walking trail, because I love the trail and hadn’t been going since my doctor told me not to take long walks.  I couldn’t figure out how long was too long.  Alice’s answer was that I should stop when my knee hurts.  Well, that’s logical, but if I wait until my knee hurts then I still have to turn around and walk all the way back.  She did say that I should be fine except if there’s an incline, and there is a big arching bridge a little ways down the trail, so I plan to try walking to the bridge and turning around at first.

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Life-Changing Encouragement and Inspiration

Yesterday was life-changing.  I’ve been chronically depressed and suicidal for quite some time, particularly over the past 6 weeks since losing my former therapist.  At my last psychiatrist appointment I even asked about ECT, feeling desperate enough to try anything.  My psychiatrist said she didn’t think it would help me, which was a crushing blow.  Then I received an e-mail from my academic adviser.

I am in the midst of one psychology class this summer, and had 3 more psychology classes and an English class scheduled for fall.  I just needed to complete those and take an exam for credit for one of the general education requirements, then I would be all set to graduate in December.  This was very significant to me, as I graduated high school in 1998 and wanted to get college finished before 2018 ended.

The e-mail from my adviser pointed out my missing general education class, saying she had put some possibilities in my registration cart to choose from.  I could not register for the course I’d been planning to test out of and no longer felt confident that I could study enough and pass the test.  I ended up registering for a class that didn’t interest me at all, bringing my fall schedule up to 15 credit hours.  Last fall when I tried 12 credit hours, I had a complete breakdown.  Or maybe four of them, as I ended up hospitalized four times that semester and another two during the spring as I was trying to finish up the 5 credit hour course in which I had taken an incomplete.

My response to my adviser was that I had registered for the class, but don’t expect to make it to graduation anyway.  After some probing, she ended up getting the e-mail that rambled about how awful everything is and how I don’t expect to be alive.  Cue her request to meet in person.

Yesterday was that meeting.  I walked in feeling crushed under the pressure.  Not only did I have 15 credit hours registered, but two of my courses were on campus, leaving me to make the roughly 45 minute (each way) drive four days a week.  I have extreme anxiety about driving, especially on the interstate and especially around that particular set of on/off ramps where the traffic is such that I chant “Please don’t die” as I merge in.

My adviser knew that my mother had driven me to campus for all the classes I had with her last fall.  Said mother had just told me that if I couldn’t manage the driving she would be willing to drive me (close to 64 trips to and from campus) as long as we put the wear and tear on my car instead of hers.  Even so, not being able to do it myself is hard on my self-esteem.  My adviser helped me identify alternate routes to campus, which might take longer but involve less stress.

My adviser said that I seem to become more and more panicked the closer I get to graduation, and suggested that I aim to graduate in December, as scheduled, but apply right now to start graduate school in clinical mental health counseling next January.  She said I’d be a shoo-in, which surprised and flattered me.  Then she looked at my fall schedule and realized, as I had already known, that it was far too much.  Another series of hospitalizations was almost inevitable if I proceeded with that plan.

My adviser then asked me which would make me feel worse: postponing graduation by another semester, or losing the 4.0 GPA that I’ve worked so hard to maintain?  Even though the GPA means very little after graduation, and even though my therapist and I are working to reduce my perfectionism, I recognized that I could come to terms with graduating in Spring 2019 far more easily than with the sense of failure I’d get from a drop in my GPA.  She told me to talk it over with mom, let her know afterward if I was postponing graduation or not, and if I was then drop the general education class and the last elective psychology class.

She enticed me with the fact that I could instead wait until spring and take both the general education class that I’ve already studied for and the criminal behavior class that she teaches.  I don’t know if she knew how much I had wanted to take that class of hers, but given the number of criminal justice and forensics classes I transferred in, that should have been easy to spot.

Mom asked if I’d have taken the same advice if she’d given it, and I wouldn’t have, but that’s because she didn’t have the information and encouragement to offer me that I received from my adviser (who still wants me to go straight to grad school, just a semester later).  I realized later in the day that this delay also benefited me in two other ways.

First, I had previously been a theatre major, and when I transferred they did not assign my theatre credits to equivalent courses, simply calling them “elective transfer credit”.  I was only one class short of the English minor, so I decided it was easier to take that class than to try getting my transfer credits reevaluated.  However, this has been nagging at me, as theatre was so important to me for so much of my life and I feel I’ve earned that minor.  Now that I have more time, I will pursue trying to get my credits reevaluated.

Second, my college offers a leadership program that involves attending several seminars and doing a day of community service.  It earns the participant an honor cord to wear at graduation, and the requirements have to be met within one academic year.  I did not make it to enough seminars last year to complete the program, and staying in school that extra semester will give me another opportunity to attempt it.

So I felt a sense of relief.  My adviser quite wisely asked if I wanted to die or just wanted to reduce my stress, and of course it was the latter.  I just didn’t see a way out, and she found me a solution.  The day continued to be life-changing even after that appointment ended.  In the evening, a friend and I traveled about an hour from home to speak at a NAMI Family-to-Family class.  My friend was speaking about advocacy, and I about my personal experience of mental illness.

In a way, I was experimenting on these students.  In my previous public speaking experiences, I’ve written a formal speech, rehearsed it obsessively, and ended up reading from the paper.  This time I decided to wing it.  I was definitely less polished than in the past, but the students were very engaged and asking good questions, and when I said I was honored to be asked to speak they said that they were the ones who were honored.  Multiple people came up to me afterward to praise me and offer encouragement to utilize my energy and passion to help others.

I’d been shying away from my volunteer work lately, mainly due to the depression, and I felt invigorated and inspired.  I also felt a new sense of self-confidence about having gotten up there and spoken from the heart and not had to obsessively prepare in order to do a good job.  I’m not sure where my volunteer work will go from here, but my heart is back in it.

At the End of My Rope

I can’t let it go
I’m at the end of my rope
I needed someone to show me everything
And I thought you could wait
Through my missteps and mistakes
I needed someone to say
That you’d be here anyway
–Sister Hazel, “Anyway”

A few weeks ago, Sadie said to me, “Even if I’m frustrated I’ll be here, and even if you’re frustrated I’ll be here.”  I took so much comfort in that statement, and it was a lie.  My missteps and mistakes were too much for her.  I was doing something I see as completely innocent and harmless, and she sees it very differently and became furious with me.  She cancelled my next appointment because she couldn’t face me, and the next week she said just about every hurtful thing it is possible to say to another human being.

Sierra is taking over as my therapist starting tomorrow, and I am terrified to even speak to her, because I don’t trust that she won’t turn on me the way Sadie did.  Even if I do manage to trust, I can’t spend that time processing the pain I’m in, because I have too much else to deal with in the immediate moment.

I’ve wanted to move out on my own for…well, my entire adult life.  A friend wants me to share an apartment with her, which isn’t quite what I had in mind, but is realistically the only way I’m getting out of this house.  It’s not as simple as just moving in together though.  She is the one who knows how to find housing, but I’m the one who has to do it.  Plus we need to be able to accommodate an additional two adults and a toddler for an indefinite period of time.  If we can’t do that, we can’t get the apartment at all and she’ll stay where she is and I’ll stay where I am.  This is all terrifying to me.  I feel like an ignorant child.

The Positivity Kit

Eleven days ago I called the hospital where I had my two November inpatient stays to ask about admitting myself.  Ever since my psychiatrist failed to tell me that my latest suicide plan was non-fatal, I’ve been obsessed with dying.  I didn’t want to die.  I have so many things to live for.  I just feared the 10% chance that impulsivity would overtake me and I’d wind up dead.  Just as I was feeling I needed to go to the hospital, Sadie told me that Sierra suggested a therapy vacation.  (As it turns out, she only meant individual therapy, not DBT group, and DBT group is what I was actually burnt out on.)

So I was in the three week time span of this “vacation” when I called and asked if I could be admitted.  The hospital is in a neighboring state, and the admissions nurse was prepared to have me drive up there and come in, until she found out I have out-of-state Medicaid.  She told me they absolutely would not admit anyone under those circumstances.  Except…I was there twice last fall, with the same insurance situation.

I called again the next day, hoping someone else would give me a different answer.  It took over two hours to receive a call back, then that nurse said she’d need to transfer me to the financial department.  I left a message there, and never received a return call.  Around 6 pm I had mom take me to the local ER, in hopes that the staff there could facilitate a transfer as they had in the past.

I met with an on-call therapist, Charles, who I had previously met and hated.  He didn’t think a 10% chance of suicide was worth worrying about, but it’s not his call, and the on-call psychiatrist disagreed.  The plan was to try getting me admitted to the hospital I’d called, and if they wouldn’t take me I’d be willing to be admitted locally.

That’s not what happened.  Through a series of lack of communication and being bullied by ER staff, I ended up at an unfamiliar hospital in my state, but two-and-a-half hours from home.  I had been prepared to tell the staff at my preferred hospital to keep me at least a week no matter what I said trying to convince them otherwise.  I know me.  I know I will try to get out.  That’s exactly what I did at this new hospital.  I didn’t even give it a chance.  I just freaked out and in less than 24 hours had signed an AMA form (to be discharged against medical advice).

The psychiatrist who saw me the next day said that, since I actually wanted to leave Monday, I needed to fill out the form again.  This made no sense to me or to any other staff, except that one nurse suggested he was using it as a loophole, because he had to choose between discharging me AMA or getting a 72-hour emergency detention from a judge and maybe he really disliked both options.

At any rate, I saw the normal weekday psychiatrist for the first time on Monday, and by 9 pm Monday night I was back home.  I knew almost as soon as I left that this was a horrible mistake, and it doesn’t seem like my mom even cares.  The closest she came to seeming concerned was to interrupt a sobbing meltdown yesterday to ask if she needed to call 911, to which my response was, “That would land me in jail because I would fight their asses.”  I would.  I adore cops, but there is no way in hell I am ever letting one take me to a hospital again.

So where does the “positivity” in the title come from?  Well, to explain that I must first explain the turtle.

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On Sunday we had the option of leaving the unit for art therapy.  This is normally my favorite part of any inpatient stay.  Not so much this time.  The art room was crowded with furniture and way too many people.  The tables were filthy with paint smears and plaster dust.  Then, instead of announcing a project, the art therapist gave us a quick tour of what was in every drawer and cabinet, and told us to engage in free expression.  I was anxious in that room and overwhelmed by the choices.  I chose the fuse beads because those supplies were already sitting out, on a table away from the rest of the crowd.  I had my turtle ready in record time, then asked if I could please stand in the doorway because the room made me anxious.  They went so far as to let me sit on the floor in the hall.

I looked at my turtle all the time during the rest of my stay.  Despite the suffering associated with him, I think he may be my favorite thing I’ve ever made in a hospital.  Then I stumbled upon a book titled The Positivity Kit by Lisa Currie.  It was marked on the front that we should have copies made rather than writing in the book.  As with the art room, I was far too overwhelmed to choose pages, so I asked a staff member to copy four or five random pages for me.  When I got home I ordered the book for myself.

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I have yet to even write my name on the first page as the book instructs me to do, but I hope to make it a colorful reminder of happy memories and wishes for the future.

Stolen Freedom

On Monday I had an appointment with Sadie.  I wanted to summarize the week since I’d last seen her before addressing my real issue, which was a friend who was staying with me.  I didn’t even get to summarize the positive parts (including seeing a play and going to a sober prom), because I briefly mentioned a suicide plan I’d had for about two days, and that led into a lecture on needing to adjust my attitude so that I can be content within my current life circumstances.  45 minutes of lecture, and then Sadie completely blindsided me by wanting to send me to inpatient.  I didn’t need that.  I was not in danger.  I had pills on hand, but did not intend to use them.  In the past she would have had me call my mom to dispose of them, but this time she leaped straight to inpatient.

I specifically said I didn’t want to go to the inpatient unit affiliated with her organization.  So what happened?  She contacted my psychiatrist and arranged for a direct admission to the very inpatient unit I didn’t want to go to.  I had a 10 minute time limit to arrive at the main center before the police would be called.  Don’t think I didn’t look at my gas gauge and calculate how far away I could get if I fled.  But I did what I desperately did not want to do and drove straight to the main center.  My psychiatrist spoke with me for about 10 seconds, reiterating her decision to admit me despite my objections, and then I sat in the waiting room for THREE HOURS AND THIRTY TWO MINUTES.

Initially I was waiting with a friend who was also being admitted.  They even ordered us lunch trays from the cafeteria and we ate them in the waiting room.  My friend had arrived first, so he was admitted first, leaving me to wait there alone.  When I finally got admitted, I saw that a “friend” who had gone missing weeks ago was there.  I do like her, but I don’t consider her a close friend, and guess what?  She found out I was about to be admitted and told all the staff that I was her best friend.  I quickly corrected that misconception!  She would not leave me alone, even when I specifically stated that I’d like to be alone.  She would not let me visit with my mother in peace or eat in peace or journal in peace.  I hid in my room whenever possible to avoid her.

Every time I spoke to a staff member I had two things to say: that I didn’t belong there and that this other patient was causing problems for me.  On the first full day, the nurse who went over my treatment plan hinted that leaving that day might be possible, but my psychiatrist said, “Maybe tomorrow, but that’s not a promise.”  I was asked if it was okay for a certain other patient to move into my room with me, and I didn’t feel like it was a real choice, so I said okay, before realizing that her psychotic ranting would keep me up all night.  When I tried to hide in my room to get away from the first problem patient, she came in and was talking about murdering people, and was not completely caught up in her hallucinations as she made references specifically to what I was doing and wearing.  I was terrified.

I didn’t know what to do.  I just wanted out of there as fast as possible.  I went to hide in the back bathroom, where I screamed at the top of my lungs.  Jan, the prior on-call therapist who has been covering some shifts lately, ran out of her office saying, “Did anyone else hear that?”  The staff said no, some patients said yes.  She went around locating patients and I heard her ask where I was.  A moment later she was knocking at the bathroom door and calling my name.

I ran out, frantically saying, “You have to get me out of here.  There isn’t anywhere safe.”  After we talked, she said that she would talk to the staff about letting me sleep in the quiet room that night.  The quiet room is scary too – restraints built into the bed – but still less scary than spending the night thinking my roommate might strangle me in my sleep.

When evening came, I asked the nurse who brought my meds about sleeping in the quiet room.  He said, “I don’t think that’s going to be possible tonight.”  About 10 seconds later I was invited out for snacks and a different nurse informed me that I didn’t need to worry because they had moved my roommate again.

I did manage to go home after two nights, but that’s two nights of my life that I can never have back.  I don’t understand why Sadie felt the need to send me there.  I thought she knew me well enough to know that if I need to be in the hospital to stay safe I will be the first person to say so.

Also, that particular inpatient unit, which I didn’t want to go to, is completely useless.  No actual treatment takes place, and it’s basically like the drunk tank in jail.  They lock you up until they think you’ve sobered up.  The real tragedy here is that I no longer trust Sadie.  I have always been honest with her, even sometimes sending an e-mail if I accidentally lied by omission, but I know there are going to be intentional omissions now and therefore therapy is a complete waste of time for both of us.  She will never again be the person I confide in when I’m feeling really down.  This is exactly the opposite of what she’s been trying to accomplish with pushing me to express my emotions and not put on a smile to make everyone else feel better.

I hate this.  I hate all of it.  I had asked my psychiatrist if I could become a meds-only client and discontinue therapy, and Sadie’s response was that I was obviously angry with her about something.  I was, but that wasn’t the whole story.  The few weeks I managed to not see her were some of the best weeks of my life.  I know therapy isn’t meant to make me feel good, but I shouldn’t leave feeling a thousand times worse than when I came in.  There’s something wrong if I am in a great mood when I arrive, and then go sob in my car after the appointment.

Top Reads of 2017

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2017 was a light year for reading.  I had to make my way through several lengthy textbooks and that plus the struggles I had with my mental health led to not reading nearly as many books as in recent years.  Thus, I only found three to be highly recommended.

  1. The Buddha and the Borderline by Kiera Van Gelder – A memoir about recovering from Borderline Personality Disorder, this book artfully describes the reality of living with the disorder and how Dialectical Behavior Therapy (and its roots in Buddhism) led the author to a more manageable life.
  2. Turtles All the Way Down by John Green – This is a mystery in the vein of the author’s past book, Paper Towns, only the main character spends much of the time caught up in “invasives” – the obsessive thoughts that Obsessive Compulsive Disorder is named for.  The descriptions of her thought processes are very poetic and insightful.
  3. No Mud, No Lotus by Thich Nhat Hanh – Inspired by The Buddha and the Borderline, I began reading books on Buddhism.  Among several books I read in a short span, this one on relieving suffering helped me the most.  In DBT group we often discuss how rumination turns pain into suffering, and I have a strong tendency toward rumination.

Running

I haven’t blogged in 3 months. When last we met, I had recently been released from the local inpatient unit where I have always gone for treatment. While there, I ran into one of my former clients, and the on-call therapist who had admitted me didn’t seem to care.

Fast forward to October and my former employment was suddenly a problem. I went for so many emergency assessments and kept being sent home. At one point I ran away during an assessment and was certain the police were chasing me. My mom took me back, but after a long wait, when they were just about to admit me, the receptionist butted in to say I was supposed to call a facility 2 hours from home for a phone assessment so they could transfer me there. Ages later, that place hadn’t returned my call and mom stormed out, taking me with her.

Not long after that I overdosed on 3 days worth of my meds plus a handful of Valium. I was not conscious enough to know what I was doing when I signed paperwork in the ER and agreed unwittingly to go to a facility 1.5 hours from home. It was much like I imagine prison life, and I mainly got through it because Bree was there too. I put in my mandatory 5 days and was offered a choice between going home and checking myself in. Obviously I went home. The only benefit to that facility was that my aunt and uncle lived nearby.

The next month was October. Sadie wanted me back in the hospital and this time I was prepared to choose one for myself. I went to a very well-known and well-respected facility in the next state, less than an hour from home, and it was a great and helpful place. However, I was discharged as soon as I rated my depression a zero one day. I know my moods don’t work that way, but I didn’t argue because I had a wedding and an honor society induction that I didn’t want to miss.

When I admitted to Sadie that I had left too early she sent me back. My moods were all over the place. I ran away from the ER while waiting for transport, so they took away my clothes. I came down with a nasty cold the day of my admission and I was badly behaved while there. I’m so ashamed of how I acted and the fact that I left too soon again and turned down the follow-up treatment I was offered. It was hard to be both mentally and physically ill at once.

I managed to complete 7 of my 12 credit hours without losing my 4.0 GPA. The other professor gave me an incomplete and I have until the end of Spring semester to finish.

Lately all I’ve done is wish I were back in the hospital. The last time the on-call therapist arranged a transfer for me she said, “We have to break the cycle of you taking up a hospital bed every time you want to run away from your life.” It hurt a lot and was the reason I ran away from the ER. My irrational brain twisted that into thinking someone else would die if I took that bed.

I have an appointment with Sierra tomorrow since Sadie is on vacation and I really don’t know what to expect. I run from my life but I also run from treatment and Sadie has no idea what to do with me anymore.