Inpatient Summary

Just over a month ago, in Oops, I Did It Again, I talked about an appointment with Brent in which I expressed some suicidal ideation and he did not think I needed to be in inpatient.  Fast-forward a week to A Narrow Miss and I had developed a plan (a combination of pills on January 1st) and Sadie reluctantly let me leave after signing a safety contract.

The plan was only to be enacted if life didn’t improve before the 1st, and life did improve.  I bought a car only 2 weeks after totalling the previous one.  It’s the same model and same year, just a different color (and in slightly better condition).  I also adopted another cat, a very sweet-tempered Russian Blue.  I no longer wanted to die.

Even so, I felt there was about a 10% chance of me acting on the plan anyway.  I felt like I was going to fail by not following through.  I was also feeling physical heartache over every little thing that happened.  Despite my goal to get through all of 2015 without going to inpatient, I packed a bag and told Sadie that I thought it was time to go.  I had to go to work doing yearly inventory, but on the 31st I had appointments with both Sadie and Brent scheduled and I fully expected to go to inpatient after seeing them.

Sadie was in favor of inpatient.  She seemed to think that I would be okay if I didn’t go, but was concerned about that 10% chance of suicide.  I was feeling a little better when I saw her, but the thoughts still wouldn’t leave my mind and she felt that inpatient would be willing to admit me if I told them the same things I had told her.  I decided I would go to my appointment with Brent before making my final decision, but I really expected to be admitted.

It didn’t happen.  I wasn’t feeling suicidal right that second and Brent said there was no reason for me to be in inpatient.  So I went home, crying, and the next day I went to work with a bottle of Wellbutrin in my purse.  I spent all day obsessing over taking it.  Work was slow, so there was plenty of time to obsess.  I managed to get through the day without taking the pills, but after texting with a friend I was pretty convinced I should go to the ER.  I didn’t want my mom to be mad at me though, so I went home after work.

I was staring off into space when mom asked what I was thinking.  I said, “I don’t want you to be mad at me…”  She said, “But you want to go to the hospital and be admitted.”  She said she would take me, but then she put her nightgown on.  She said I could have her get dressed again, but I couldn’t work up the courage to ask.

The next day we went out shopping, primarily to go to an antique mall she wanted to visit.  I was feeling a lot better that day, but kept worrying.  I’m due to go to Chicago on the 9th to visit my best friend, and what if things got worse again and I did have to go to inpatient?  If I didn’t go right away, I probably wouldn’t get out in time.  So when we got home from shopping, I picked up the bag I’d had packed for several days and we headed to the ER.

Bear in mind that I work at the local hospital and pass through the ER on almost a daily basis.  The nurse practitioner they sent to see me was a stranger, as was the nurse who took my vitals, but when I pressed the call button to ask for water it was a unit clerk I know who came in.  He brought me two bottles of water and didn’t act weird at all about the fact that I was there, despite knowing that I was waiting for the on-call therapist to show up.  In fact, he had to call over to CMHC after I’d been waiting over an hour, as the on-call therapist was late.

When the on-call therapist, a man I hadn’t met before, did show up, I explained why I was there and he agreed that inpatient seemed like a good idea, so he called the psychiatrist to get approval.  I signed the paperwork to be transferred into inpatient, and he walked me downstairs and through the cafeteria, and when I set foot in the cafeteria I started panicking and whispering to mom, “I can’t do this.  Don’t make me do this.”  I expected her to stop the on-call therapist and ask if there was a way for me to back out, but instead she just said, “Too late, sweetie.”

I did calm down once I actually got inside and started the admissions process.  Stories from my stay will be forthcoming, but at this point I’ll just summarize that I was there for 4 nights and got one med adjustment.  They kept all my existing meds, but at my prompting added Lamictal.  At this point I’m taking 25 mg twice a day, and the next dose increase probably won’t happen until I see Brent on the 27th.

The other important point is that, when I was released yesterday, I was expecting to go to an appointment with Sadie that afternoon.  I called over from the inpatient unit to verify I still had the appointment and found out it had been cancelled.  I was panicking all over the place, shaking and pacing around the room.  Jean passed through and asked how I was, and I said, “Not good.  Anxious.”  She asked why and when I explained she told me to go to the nurse’s desk and ask the people there to call and try to get me another appointment.

It turns out, one of those people was the one who cancelled my appointment.  I was pissed, but remained civilized.  She did try to get me an appointment but they didn’t have anything available except for a day in the middle of my trip.  I was still a bit panicked when mom arrived to pick me up, but it resolved later in the day.  I e-mailed Sadie to tell her I was sorry I wouldn’t see her until after the trip and she ended up having a time available on Friday morning.  I’ll have to cut it a little short in order to get to work on time, but I’m so relieved I’ll get to see her.

Oops, I Did It Again

About a year and a half ago I detailed my first car accident in Life Experiences That No One Needs.  I didn’t need it the first time, and I definitely didn’t need it again.

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To start at the beginning, I went to work at the hospital at 7 am Tuesday.  Around 9:30 the phone rang with a call from an outside line.  I never answer these calls, as they’re never for me, but I was sitting at the desk and happened to glance up at the phone and see that the number was my mom’s cell phone.  I got excited, thinking she’d gotten the call that a kidney was available for her.  The actual purpose of her call was much less exciting.  She said that she had fallen and thought her wrist was broken.  She asked me to come get her and take her to the ER.

I got off the phone and rushed to the back room where a coworker was filling in for the crew lead who is on vacation.  I frantically told her I needed to leave and why, and she told me to drive carefully.  I did, and the 10 minute drive to home felt like it took hours.  I brought mom to the ER, waited around with her for what felt like more hours, and she learned that her wrist was just sprained.  She got a wrist splint and was released.

Mom had been planning to get a blood test redone that day and asked if it was okay if she did that before I took her home.  At this point I’d missed so much of work I figured it didn’t matter, and went with her to the outpatient lab.  I finally got her home and headed back toward work.

A couple of miles from work, I was going around a curve when the car slid on the wet road and went into the other lane.  As I tried to correct it, the car slid the other way, into the grass, and turned sideways and the back of the driver’s side slammed into an electric pole, breaking it in half.  I sat there, stunned, and a moment later someone pulled into the driveway of the nearby church and came running over.

I was shaking too hard to dial my phone, so she called 911 for me and waited until the police arrived.  I had some minor pain in my left knee and left upper arm, but my bigger concern was that I hyperventilated so badly that my entire torso and both arms went numb.

A county sheriff’s deputy asked me to explain what happened and took my driver’s license and insurance card.  The paramedics let me get out of the car on my own and walk to the ambulance, where they just had me sit on the bench seat and buckled me in.  A different deputy brought my license and insurance card back before we took off, and gave me the report # on her business card.  She said that the road doesn’t slope correctly on that curve and there are a lot of accidents there.  After some time to calm down, I wondered if I could file a claim against the state department of transportation due to that fact.

The ambulance took me back to the hospital, so it was kind of like getting a very expensive taxi to work.  I had to put on the sexy hospital gown and the doctor said he didn’t think anything was broken but recommended getting the x-rays anyway for peace of mind.  So I got a couple of x-rays of my knee and a couple of my upper arm, and then the x-ray technician wanted one of my elbow too.

It didn’t take long for me to be released and I headed back to work, where my supervisor asked if I was cleared for duty.  I think she might have asked if I was okay first, but that’s not what stuck in my mind.  I finished out the day and a coworker gave me a ride home.

I didn’t call mom and tell her what happened.  I thought I would wait and say it when I got home, but then I realized I was too scared to tell  her face-to-face so I texted her.  She said, “Seriously?”  As if I would joke about such a thing.

I didn’t freak out too badly until I got home and she reminded me that I needed to report the accident to my insurance.  I did so and had to answer a million questions asked by some foreign lady at a call center, and one of the questions I didn’t know the answer to so I had to call back later with that information.  Then I asked mom a question and she said I should have asked them, so she called them back and I ended up having to talk to someone again because she couldn’t answer his questions.

Juggling our schedules to share a car was a nightmare last year, and finding a new car was even more of a nightmare.  This time will be worse, because the budget is much tighter.  I don’t know how I’m going to survive this.  I was supposed to be working on that driving anxiety hierarchy and can’t make progress on that as long as I’m sharing mom’s car, if I can even get over the increased post-accident anxiety.

Then I had to drive mom to a concert she was singing in.  It was in a city I don’t normally drive in, and it was after dark.  I got almost there before I completely freaked out and had to pull over at a gas station.  She drove the last couple of miles with me having to buckle her seatbelt, start the car, and put it in gear.

The next day I had an appointment with Brent.  My notes already said that I wanted to increase my BuSpar dose, and with this turn of events I felt even more strongly about that.  He agreed to increase it to 15 mg 3x a day, but still prescribed it as PRN and told me not to take it if I don’t need it (but then turned around and reassured me that I should take it if needed and not try to suffer through the anxiety).  He was not willing to make two changes at once and I was still bringing up the idea of Lamictal, so he agreed that when I see him again in a month we will start it then and eliminate the Latuda, if I still want to at that point.

Brent has a bunch of questions he has to ask every time and one of them is “Do you have any thoughts of hurting yourself right now?”  He literally means “right now” – if it was the day before he’s not concerned.  I always say no.  I said no, and then said, “Wait, that’s a lie.”  Last night around the time I was talking to the insurance company I started planning to buy a couple of bottles of Benadryl.  Surely if 40 pills screwed me up as bad as they did, 200 would do the trick.  I didn’t get a chance to buy them because mom was with me, but I was still considering it even when sitting in the waiting room before my appointment.

I kind of spaced out and Brent asked me a question that I swear sounded like something about coffee.  I have a bad habit of not asking people to repeat themselves and just giving a vague answer and hoping it’s right.  So I said, “No.”  The question was whether I would call if I needed help.  Oops.  I didn’t understand the next question either and this time did ask him to repeat it.  He wanted to know if I needed to be in inpatient.  He said he had no grounds for making me go there.  Really?  I just admitted to current suicidal ideation and there are NO grounds?  I would have expected at least tiny ones.

I said I’d avoided going for a year and now was aiming to get through all of 2015.  He asked again if I’d call for help (this time I said yes) and he repeatedly assured me that if I called he’d squeeze me in, even the same day.

Later in the day, I also had an appointment with Sadie.  We focused primarily on the obstacles this development would present for working on my driving anxiety.  At this point mom and I are sharing a car, which means I can only take it for necessities, such as work and therapy.  That rules out doing any of the steps on my hierarchy, given that even when I had my own car mom told me not to do them because they were “too dangerous”.

Sadie said it was crystal clear why I had anxiety.  At another point she said she’d like a session with my mom to tell her to stop sabotaging what we’re working on.

I had committed to doing the first four steps during the week between appointments, and I did complete those, plus three more.  I practiced making left turns onto and off of the US highway, and Tuesday night I drove someplace new locally by dropping off my car keys at the towing company.  Sadie was excited that I managed 1/3 of the list in a week, but I still need more practice at the left turns, and all the other steps on the list are harder and more time-consuming.

One Year of Treatment

On this day one year ago, I was Celebrating February 14th.  It’s been a long, hard year since then.  While I was released from that visit with a mere Contract for Safety, I was back at the ER a month later, being admitted to the inpatient unit because I was dangerously suicidal.  I had another three inpatient stays throughout the year, including one that followed an overdose of Benadryl.

I’ve signed at least half a dozen Contracts for Safety and laughed at the idea of many more.  I’m no longer asked to sign them.  I’ve had a total of 63 therapy sessions across 3 therapists.

I’ve gone every month or two to the psych APRN to have medications adjusted.  Each time that he has set the appointments 2 months apart, something has happened halfway between them.  The first time, I ended up in inpatient.  The second time, I had to call him with a problem, and still ended up in inpatient.  The third time, he gave me permission to call for a sooner appointment and I did.

Currently I take Wellbutrin, Latuda, and BuSpar, with a few leftover trazodone on hand in case I can’t sleep.  During the past year I’ve also taken Seroquel (made me suicidal) and Abilify (didn’t seem to help as much as the Latuda).

A month ago, I started attending DBT group therapy each week.  Next week I have an interview with Vocational Rehabilitation to see if they’ll pay to have the supported employment services help me with job hunting, as anxiety led to me quitting my full-time job in December.

As I said, a long, hard year, but things are starting to look up.  Not only do I not want to kill myself, but I’m no longer passively suicidal and am even starting to find some enjoyment in activities again.  I still feel pretty hopeless about my life as a whole, but at least I have some ability to take steps toward a better future.

One such step, which I’ve been planning for some time, is the writing of a book about this first year of treatment.  I have some ideas of information I’d want to include, but am opening this question up to readers: what would you be interested in reading more about if I were to write such a book?

The Cost of an Overdose

As it turns out, overdosing is mighty expensive. It has been 28 days since I overdosed, and the bills have poured in to my insurance company. Here is a breakdown of all the charges, with original cost and insurance-approved cost in parentheses:

AMBULANCE
* ALS1-EMERGENCY ($1,100 -> $400.06)
* GROUND MILEAGE ($112 -> $50.12)
* AMBULANCE O2 LIFE SUSTAINING ($35 -> $0)

EMERGENCY ROOM DOCTOR
* EMERGENCY SERVICES ($506 -> $332.16)
* ELECTROCARDIOGRAM REPORT ($25 -> $17.78)

ICU DOCTOR
* INPATIENT PHYSICIAN SERVICE ($501 -> $233.99)

COUNTY HOSPITAL
* MISCELLANEOUS SERVICES ($42.15 -> $34.14)
* MISCELLANEOUS SERVICES ($58.72 -> $47.56)
* MISCELLANEOUS SERVICES ($8.60 -> $6.97)
* MISCELLANEOUS SERVICES ($47.10 -> $38.15)
* MISCELLANEOUS SERVICES ($67.40 -> $54.59)
* COMPREHEN METABOLIC PANEL ($322.40 -> $261.14)
* ASSAY BLOOD ETHANOL ($105.00 -> $85.05)
* ASSAY URINE ACETAMINOPHEN ($159.60 -> $129.28)
* THERAPEUTIC DRUG ASSAY ($97 -> $78.57)
* DRUG SCRN 1+ CLASS NONCHROMO ($250 -> $202.50)
* AUTOMAT HEMOGRAM-COMPLET DIF ($77.50 -> $62.78)
* AUTOMATED, WITHOUT MICRO ($48.60 -> $39.37)
* CRITICAL CARE FIRST 30-74 MN ($693.20 -> $561.49)
* NONINVAS EAR/PULSE OXIM;SING ($88 -> $71.28)
* ELECTROCARDIOGRAM, TRACING ($207.90 -> $168.40)
* INPATIENT PHYSICIAN SERVICE ($584.70 -> $473.61)
* MEDICAL SERVICES ($75.40 -> $61.07)
* ELECTROCARDIOGRAM REPORT ($26.70 -> $21.63)

ON-CALL THERAPIST
* MEDICAL SERVICES ($82.50 -> $58)

MENTAL HEALTH CENTER INPATIENT UNIT
* MISCELLANEOUS SERVICES ($2,000 -> $1,050)
* MISCELLANEOUS SERVICES ($56.33 -> $0)

PSYCHIATRIC APRN
* INPATIENT PHYSICIAN SERVICE ($85 -> $85)
* INPATIENT PHYSICIAN SERVICE ($75 -> $65)

The grand total was $7,537.80, of which my insurance approved $4,689.69. Fortunately for me, I had already reached my maximum coinsurance for the year and did not have to pay a cent of this. Unfortunately for the purposes of this post, I cannot give an idea of what the out-of-pocket cost would have been.

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The real cost of an overdose isn’t monetary though. It’s the risk of having permanently damaged internal organs. It’s the awkward silence when you try to explain what you were thinking, or possibly not thinking. It’s the knowledge that everyone is looking at you distrustfully, wondering how long until you try it again. It’s the awful realization that you could very well be dead, and after coming that close you understand that you never wanted that to happen. It’s the fact that once you’ve overdosed, it continues sounding like a legitimate solution, no matter how mild your depression may be.

Keeping the Stories Straight

At the beginning of Thanksgiving week, I got up in the middle of the night, stumbled around my living room, and went crashing to the floor.  I couldn’t get up.  I screamed for my mother, who leaped out of bed and came to help.  Then, of course, I refused her help.  I managed to pull myself into a dining room chair, but was shaking too hard to drink the glass of water she brought for me.

After some interrogation she asked if I had taken a bunch of pills.  I denied it.  Then she asked again and I confirmed it.  In total, I had taken somewhere between 40 and 50 Benadryl.  When mom realized she couldn’t get me to the hospital on her own, she called 911.

benadryl

Many hours of my life are a blur.  I thought I remembered the presence of “Deputy Wayne” from Celebrating February 14th.  This made no sense, so I assumed I hallucinated.  I remembered ambulance lights and being helped outside to get in it.  I remembered a bedpan.  That’s about all until I woke up hours later in the ICU.

Things were not much clearer in the ICU.  From that portion of the day, I remember repeatedly getting out of bed.  I remember trying to yank out my IV needle.  I remember a really sweet nurse who offered to order my meals for me so I wouldn’t have to make scary phone calls.  I remember the on-call therapist dropping by to determine whether I should be admitted to inpatient, but I don’t remember the slightest thing about what I said to her.  I remember mom visiting and telling me that Deputy Wayne really had been there, but I had to ask her about it all again the next day because I wasn’t sure I hadn’t also hallucinated the conversation in which she confirmed his presence.

I told many different stories about the overdose – some of them during the time when I was not coherent enough to know what I was saying, and others during the course of the following week when everyone wanted an explanation for what I’d done.  Some of the stories:

“I did it for attention.”
“I don’t know why I did it.”
“I wasn’t trying to kill myself.”
“I wanted to hurt myself.”
“I took a few for sleep and it impaired my judgment so I took more.”
“I overdosed on Benadryl.”  (no reason given)
“I tried to kill myself.”

In the beginning, “I don’t know why I did it” was pretty close to the truth.  This was what I told my psych APRN when he came to see me the next morning in inpatient.  He tasked me with figuring out the reason(s) I did it so we could prevent it from happening again.

I told most of my friends that it was an accident.  That I took them for sleep and took a few more when they weren’t helping, and took a lot more when my judgment became impaired.  The truth in that was that I did only take a few at first and my judgment really was impaired by the time I took the rest.

I told one close friend that I wanted to hurt myself, but wasn’t trying to kill myself.  I did want to hurt myself.  I had wanted to hurt myself for days.  I didn’t plan to kill myself, although suicidal thoughts had been stuck in my head just as long.

With a few people, I didn’t give them a reason and let them make their own assumptions about what happened.  With one particular person, I needed to impress upon him the severity of the situation, so I said I tried to kill myself.  This is sort of true too…I did try, even if it wasn’t entirely intentional.

It took me a while to figure out exactly what happened and why and how to explain it, so here’s the truth:

I had been having suicidal and self-injurious thoughts for days.  The kind of thoughts for which I’m expected to call the local mental health center’s emergency hotline.  The kind of thoughts I didn’t think were that much of an emergency and surely I could handle them myself.  The afternoon of the overdose, a friend confided in me that she had been suicidal the night before, for the first time in her life.  She said the only reason she didn’t do it is because she had a “painless and tidy” method in mind but lacked the tools needed to execute it.  I don’t blame her for my thoughts, but it did spark something in me.  The idea that I really could do it; that nothing was stopping me.

I didn’t really plan on dying.  I didn’t make any sort of preparations.  I just knew that I had once taken 10 Benadryl with no lasting effects so maybe this time I could try 15.  I was clearly a chicken about it, because I only took 5 at a time, giving myself the chance to back out.  5 pills every half hour, until I reached 15.  Then 20.  At 20 I still felt fine, if somewhat groggy.  I dumped another huge pile in my hand, tossed them in my mouth, and swallowed.  I knew when I took all those at once that it could kill me, but it’s true that my judgment had been impaired.  I didn’t have the capacity to make a decision about whether I wanted to die.

I was terrified going into inpatient this time.  I was convinced I would be permanently committed.  In reality, they only held me 2 nights.  I got 5 nights once for lying about having suicidal thoughts, but when I overdosed I only got 2 nights?  This was baffling.  I can only imagine that they were trying to get me home for Thanksgiving.  I didn’t argue on being released, not wanting to ruin Thanksgiving, but I was still very depressed the next few days and would have benefited from a longer stay.  I’m still working on learning to put my own needs first.

Life Experiences That No One Needs

Your 21-year-old car has looked a little better in its time, but it’s still running great as you coast toward a green light on the US highway that cuts through your small Midwestern town.  An oncoming car sits waiting and waiting in the turn lane, waiting through the huge gap between you and the car ahead.  As you reach the intersection, the driver abruptly turns left.  There’s a split second that lasts an hour, in which you hold your breath, choking on fear as you slam on the brakes, already knowing that the laws of physics make impact inevitable.  The noise as the two cars crush together is familiar from years of Hollywood’s most thrilling action films, but now you are inside the noise, not separated from it by a widescreen and a projection system, and it echoes in your ears long after the sound waves have dissipated.

001_wrecked-dodge-dynasty

The air bag explodes with a cloud of suffocating powder, filling the close confines of the car.  You choke, gasping for air, and somehow find the presence of mind to inch your car out of the intersection and into the driveway of the nearby high school, hoping the cloudy air and your watery eyes don’t cause you to hit anything else along the way.  You roll down the window, desperate for oxygen, and in between gulps of fresh air you fumble for your cellphone, feeling like Homer Simpson when you think, “What’s the number for 911?”  As you remember the number, you forget how to operate your phone, and as you remember that your fingers forget how to move without shaking uncontrollably.

You have just managed to dial for help when you’re interrupted by a voice at your window, spilling out of the lips of a man in a blindingly fluorescent yellow vest.  You wish he would go away, and let you finish doing the responsible thing.  You try to focus on the voice on the other end of the phone, asking for the location of your emergency, and when you name the intersection the voice asks you what city you are in.  The rest of the call is a blur, and after you hang up you are surrounded on all sides by witnesses reassuring you that the accident was totally the other driver’s fault and that they are staying to give a statement.

It seems like mere seconds between the end of your phone call and the beginning of sirens, and it may very well be seconds given how tiny this town is.  The fluorescent yellow vest belongs to a man who has identified himself as a volunteer firefighter who happened to witness the accident.  He keeps telling you not to move, and you are incapable of listening, trying to reach for the window handle on the passenger side, reach for the hood release when the official firefighters show up.

You won’t realize until days later that you never give a thought to the condition of the other driver, as you sit there filling with panic and trying to focus on the paramedic’s instructions, asking you what hurts and whether you can squeeze his fingers.  In the back of your mind, you’re convinced that you’re okay, but you know what happened a few weeks ago when you thought the same thing after taking a tumble on an icy sidewalk.  You know that even if your body isn’t hurt, your fragile emotional state is well on its way there, so you agree to go to the hospital.

This is when things take a turn for the embarrassing.  Out comes the neck brace, which does its job of immobilizing you – perhaps too well, as your chin no longer functions when you try to answer an onslaught of questions.  Out comes the backboard and you are surrounded by dozens of disembodied hands trying to pull you onto it and out of the driver’s seat as gently as possible, which is, as it turns out, not that gently.

You lie on the backboard on the stretcher, face to the sky, being pelted by raindrops in Mother Nature’s sick game of Chinese water torture.  You reach blindly, unable to open your eyes in this weather, for the wallet tucked into your lunch sack, and successfully present your driver’s license and insurance card to the person you have to assume is a police officer.  You seem to lie here in the rain forever, the sky crying tears you are still too shocked to muster, before finally being loaded into an ambulance.

After a series of steps to secure you in place, and the removal of a glaring light that still prevents your eyes from opening, the ambulance takes off, blaring its sirens as you think, “This is not an emergency!”  It is a small town though, low on excitement, and clearly the paramedics will take any opportunity to show off their siren.  You jostle and bump along, then head up a steep hill which gives you the bizarre sensation of lying down and standing at the same time.  You are thankful that your injuries are minor, as this carnival ride would have you shouting in pain otherwise.

Somehow, amid all the noise of the siren and jostling of the stretcher, you are expected to answer a series of questions, to which you can barely remember the answers.  You hesitate when asked for the name of your family doctor before finally remembering that you’ve seen your new nurse practitioner a whopping two times and she does have a name and it’s right on the tip of your tongue…  You are asked to name any medications you currently take, and hesitate again when one of them leads to a blank expression and a “What’s that one for?”  “Bipolar disorder,” you mumble.

Eventually the ride comes to an end.  It seems to have taken an awfully long time in spite of the aforementioned smallness of the town.  You are rolled out of the ambulance and into the ER, seemingly inches away from the lights zipping by overhead.  You barely notice when the combined 200 lbs of your body and the backboard is transferred from the stretcher to a hospital bed.  Someone comes to get your health insurance card and ask you a million more questions, and by now you’re so overwhelmed that you’re not going to remember anything that was said.  Except that after again asking for a list of medications, your medical history is repeated back to you as “high blood pressure, depression, anxiety, and bipolar disorder”.  Clearly someone is not up-to-date on what “bipolar disorder” means, seeing as how depression is one of the poles.

A woman offers to call your mother for you, if you can’t get a cellphone signal.  You barely get a signal, and your mother doesn’t answer, so as you are leaving a voicemail the woman has to remind you to let your mother know that you’re okay.  You do, but if you were totally okay then you wouldn’t be at the hospital, would you?

Your mother arrives in no time, and that’s when you start to cry.  You feel awful about the car and are terrified of the process of dealing with insurance companies and hunting for something new to drive.  A sweet young nurse practitioner comes in to inspect your knees and chest, and she orders x-rays of your chest and right knee.  You go off to play the most contorted game of Twister in order to have the x-rays taken.

At some point, a police officer arrives to return your driver’s license and insurance card, which is now smeary from the rain.  You think about how you’ll need to get it replaced, before remembering it’s for a car that you will no longer have.  The officer takes your statement and thankfully remarks that it matches the one given by a witness, so the insurance companies should determine that the other driver was at fault.

The results on your x-rays come back and everything looks fine, so you end up leaving with an ACE bandage on your knee and a naproxen prescription in your hand, but not before grudgingly accepting a tetanus booster.  You know you’ll spend days feeling like a bullet ripped through your triceps, but given that you work in a filthy warehouse and are exceedingly accident prone, perhaps the shot is not such a bad idea.

Celebrating February 14th

Some people celebrate Valentine’s Day by giving their sweetheart candy, flowers, and romantic candlelit dinners.  Other people celebrate Singles Awareness Day by dressing in black and moping about not having a sweetheart.  This year, I was celebrating February 14th by sleeping in on one of my “weekend” off-days, and wishing I had some Sweethearts candy.

ur-kind-sweetheart

Around 9:30 am, I had finally decided I might drag myself out of bed and do something productive with my day.  Maybe go shopping for that candy I wanted.  Actually, my bladder was making this decision for me when it was distracted by the doorbell.  I was tempted to ignore it, but thought it might be a delivery, so I threw a cardigan over my pajamas and peered out the window in the front door.  Standing on my doorstep was a nice-looking man dressed as a sheriff’s deputy.  I thought, “Awesome!  Someone sent me a strippergram!”  Imagine my disappointment when I opened the door and discovered that his badge and gun were quite real.

I stepped out onto the cold concrete in my slipper socks, pulling the door shut behind me, dreading whatever devastating news he had come to convey.  I’m sure everyone has a gut reaction to seeing law enforcement.  Mine, at least in this context, was the unshakable conviction that he would say my mother was dead.  I was startled when, after confirming my identity, he said that a friend had called about a worrisome e-mail I sent.  I put on my best expression of innocence and confusion.  Nobody wants to admit to a stranger that they have 1,001 problems, so I denied sending anything which could be construed as worrisome.  I claimed I had no idea who would have made such a call.  I was a great big lying liar.  I knew exactly which friend and which e-mail.

There are many things one shouldn’t e-mail to a friend.  “Your wedding dress made you look fat.”  “I slept with your husband.”  “My son drove over your dog.”  No matter how much truth is in these statements, you should probably keep them to yourself.  The same is true of the following:

Now I just keep crying and wanting to hurt myself (or go retrieve the booze that’s still in the trunk of my car from when I tried to give it away and my friend flaked). I so wish I could take it all back. That e-mail. All the other e-mails. This one. The ones that ended up starting this whole mess. In fact, take back that post about depression, because that really started it all. Let’s just pretend the past 6-7 weeks never happened. Because when I wrote all that I had hope, and now I have realism. In reality, none of this shit can ever get better and I’m just deluding myself by considering the possibility that it could.

As I was saying, I denied the existence of the e-mail.  The deputy (let’s call him Deputy Wayne) said, “E-mails are pretty specific.  Usually just to one person.”  I said I send a lot of e-mails, so really it could have been anyone who called.  As he kept pushing about how I must have some idea of which friend called, I found myself admitting that I had been a little depressed lately.  He asked, as though the thought had just popped into his head, if he could see my driver’s license.  As I opened the door to fetch it, I realized how rude I was being by making him stand outside in the cold.  I’d say “mistake #1”, but that happened back when I let the doorbell persuade me out of bed.  I then allowed myself to be swayed by the fact that my typically territorial cat came to investigate the stranger and behaved in a friendly manner.  Obviously he couldn’t be too bad if she declined to hiss and claw at him.

Having not been awake to take a look around the house, I was unaware of the scene behind my back, which Deputy Wayne was surveying as we stood awkwardly in the living room.  He asked what kind of health problems I have, and I’m sure I looked befuddled as I answered, “None.”  He said, “That’s a lot of medication for someone with no health problems.”  I had no idea until later that he was seeing approximately 20 empty pill bottles my mother had left on the dining room table when she got distracted on the way to the recycling bin.  It didn’t matter exactly what he saw though, as I knew to explain they were my mom’s rather than mine.

When I tried to explain her health situation while passing it off as something I am totally okay with, we slipped into a chat about topics not entirely focused on me.  My guard slipped as well.  I could sense him wondering if maybe it was okay to leave, maybe my friend had overreacted, but he kept asking if I was absolutely sure I was okay.

Now, this was not my first experience of having friends call the cops to check on me.  However, the previous time was in college 7 years earlier, and the two campus police officers who showed up at my dorm room were extremely easy to persuade that it was all a huge misunderstanding.  Deputy Wayne, on the other hand, was very kind and very skilled at his job, and his persistence wore down all the will I had to appear strong and sane and normal and happy.  All those things I wish I could be.

So it was that I ended up curled up on the couch, clutching my cuddliest cat like a security blanket, and confessing that I had lied.  That I did write to a friend about wanting to hurt myself.  That I thought maybe I might be bipolar.  I tried reassuring him that I would be fine and he was free to go.  I promised to not act on these thoughts.  He said he couldn’t take my word for it.  Thus he gave me the not-choice between voluntarily accompanying him to the emergency room and likely being released within a couple of hours, or having him take me involuntarily and being trapped there at least 24 hours.  I tried every argument I could think of, including “I can’t afford to get help.”  His answer?  “It doesn’t matter if you can afford it.  You need it.”

I grudgingly agreed to go, on the condition I could go get dressed first.  Which turned into grabbing clothes, rushing off to mom’s bathroom, peeing quite desperately, getting dressed, borrowing her mouthwash and deodorant, thinking about busting the screen out of the window and fleeing…  Obviously, I wasn’t thinking clearly about that, because I had no shoes and there was a foot of snow on the ground, and obviously Deputy Wayne would be able to track where I went from the footprints.  It was funny to consider what the neighbors would think though, seeing a sheriff’s car in my driveway and me climbing out a window.

I took so long doing all this that he came looking for me, obviously assuming I’d slashed my wrists in the bathroom or something.  It was the furthest thing from my mind.  I was genuinely not suicidal, which is why the idea of going to the emergency room seemed like the most ridiculous thing ever.  As I exited the bathroom, he asked if I wanted to ride with him or follow in my own car.  I was already brainstorming a lie about where I’d been, so I opted to drive myself.  Once we arrived at the hospital, he probably regretted giving me the choice.  Why, you ask?

I got out of the (badly parked and taking up two spots) car smiling like a loon.  Deputy Wayne asked what was so funny.  I confessed that I’d spent the entire drive there thinking about turning the opposite direction and hitting the gas as hard as I could.  Aside from the fact that I intensely wanted out of this situation, fleeing from the cops would make a really awesome, exciting story to spice up my boring life.  I could detect faint amusement as he complained about how much tedious paperwork would be involved if he had to arrest me.  My response?  “But it would be really funny!”

My experience with emergency rooms (in fact, my experience with medical personnel in general) is extremely limited.  I went for severe headaches as a child, then again for sprains in both ankles (not simultaneously) in early adulthood.  I’d never even had blood drawn, and was sure I’d throw up and/or pass out if I did.  Unfortunately, I’ve had lots and lots of experience of visiting people in hospitals, and every time I feel like I’m going to crawl out of my skin while waiting to escape.  I nervously followed Deputy Wayne inside and signed in.  We sat, we waited, we chatted.  The triage nurse called my name.  We got up and moved over to her desk.  Seriously, he was right at my side everywhere I went.

The nurse was alarmed by my blood pressure.  Sure, 182/110 is Seriously Bad, but I looked at her like she was an idiot and said, “I’m at a hospital with a police escort.”  She took it again, manually this time, and I summoned all my knowledge of relaxation techniques from acting classes to get it down to a still-too-high 160/90.

Once we got to the million questions portion of the show, I deferred to Deputy Wayne to explain why I was there.  Then I proceeded to answer “no” to virtually everything.  No, I have no allergies, no, I haven’t been diagnosed with anything EVER, no, I’ve never been pregnant.  The only non-“no” answers?  Yes, mom has a lot of the things mentioned, but as side effects from medication, yes, I have headaches a lot, yes, there’s a chance I could maybe possibly be bipolar.

Then I got my shiny, pretty hospital bracelet, and we went over to the registration desk.  As proof of how non-existent my past medical care has been, my address on file was one I haven’t lived at in 7 years, my next-of-kin’s address was one she hadn’t lived at in 16 years, and the back-up next-of-kin is deceased.  I was filled with a sense of dread when asked about insurance and I had to say I didn’t have any.  Honestly, I expected the registration lady to yell “It’s mandatory!” in a robotic voice and paralyze me with laser beams from her eyes, and a helicopter to land outside and a SWAT team to come in and arrest me for not complying with the Affordable Care Act.  This did not actually happen.

We finished registering and went back and sat and waited some more.  Deputy Wayne asked if I had social anxiety.  I thought, “I did mention how it takes 10 minutes to psych myself up to ask someone for a pen, right?”  I only said, “Not officially diagnosed.”  He commented on how well I was doing talking with him.  Yeah, because I got the right person showing up at the door.  If I’m going to be comfortable with someone, I’ll know it the second we meet.  Same if I won’t be comfortable.

Eventually I got back to an exam room, and a nurse came in and went over all the same basic questions again.  “What brings you here?”  “Him.”  Then the nurse said, “The TV works, as long as the deputy says it’s okay.”  Seriously?  I needed permission to watch television?  He said it was okay, but I was just baffled by this.  What was the alternate answer?  “No, she may have a psychotic break if she sees Judge Judy”?  (Actually, seeing Judge Judy does make me feel a little psychotic.)  At this point, Deputy Wayne gave me his business card and a hug, and told me if I need something to call anytime day or night.  Except I interrupted after “need something” to say “…don’t call you?”  I apologized for being sarcastic, but he was simultaneously saying, “You’re spunky.  I like it.”  Then he was gone.

It should be good to no longer have a cop hovering around, right?  Not so much, because if he managed to convince you to open up about what’s going on to the extent he decided you need to visit the emergency room, then you must feel pretty comfortable around him.  Then that source of comfort disappears and everything goes a little downhill as you are left sitting alone in an exam room, not knowing how long it will be until a new stranger walks in or what will happen when they eventually show up.

I spent that time fidgeting with so much nervous energy that I probably looked high, and plotting whether I could sneak out when I was directly across from the nurses’ station.  Eventually a social worker from the local mental health center (we’ll call this guy Dallas) came in and went over all the same questions, only in much more detail and I was much less comfortable talking with him.  I felt bad about that.  He seemed nice enough, and was clearly understanding and sympathetic, but he just didn’t naturally put me at ease.  So although I definitely didn’t lie about anything, I probably left out things I should have said.  He went away for a very long while, during which time the nurse came back and asked for a urine sample.  This was hard to provide, having gone 12 hours without anything to drink.

Dallas came back after what felt like a lifetime of waiting, and asked if I was ready to go home.  Absolutely!  He made me sign a “Contract for Safety” stating that I wouldn’t harm myself or others and providing information on who to contact if I felt the urge to do so.  Given that the person who clearly appreciated my sarcastic nature had left, I refrained from asking what they would do if I violated that contract.  Come arrest my dead body?  I also didn’t tell him there was no chance of me actually calling any of the numerous phone numbers he provided, as telephones and I do not get along.

The Contract for Safety also included information on a follow-up appointment he had scheduled for me.  It was scheduled on a work day.  He said I could call to reschedule.  I was fairly certain I’d be less likely to die of anxiety by speaking to my supervisor face-to-face about taking half a day off than I would be to call a stranger and reschedule.

Dallas told me he would check with the nurses to make sure they were done with me.  I slowly put on my jacket.  I slowly picked up my purse.  I saw he wasn’t standing right outside the room anymore and very, very quickly fled the building.  So, uh, I was not officially released.  Maybe 2 or 3 hours after returning home, the phone rang.  Typically the house phone ringing means a call for mom or a junk call no one wants to receive.  I sensed this time was different, and rushed to answer it.  Someone was calling from the emergency room to make sure I was okay because the ER doctor didn’t get to see me before I fled.  I said I was fine.  She invited me to return if I had any physical symptoms.  Needless to say, I did not return.

As you might expect, there were some moments where I felt angry and exasperated, but they were fleeting emotions.  Mostly, I was amused as there were some really funny moments involved, and grateful because I’d been standing in the airplane door forever, needing someone to shove me out, and I got both a firm shove and an excellent parachute.