FILE: 2015 Psych ER Report

This is extremely triggering. Read at your own discretion.

This is a ONE page report on me in the psych ER. Sobering.

Does this blog reflect what is written here? Is it a matter of "my side"/"their side"? This is how the doctors at the psych ER saw me on two separate days (in one report). I could search this blog to find what I may have written at the time. By the way, I looked it up, "anhedonia" is lack of emotion. A bipolar person without emotion? I do remember being this way, I think, however. An odd state to be in for sure. For sure, these two entries in my psych. medical record is a sobering look at my illness.

10/28/2015

Suicide ideation with a plan: Consumer denies

Danger to Others Worksheet

Severe anxiety symptoms/agitation

Employment instability

Impulsivity

Lack of insight

Currently manic or depressed or psychotic

Relationship instability

Lack of social support

Static Risk Factors

Low socioeconomic status

Aggresive or destructive behaviors

None

4/20/2015

Dynamic Risk Factors

-Severe anhedonia

-Severe depression

-Hopelessness

-Suicide ideation or intent

-Suicide plan

Static Risk Factors

-Mood disorder

-Psychotic disorder

-History of suicide attempts

Agressive or Destructive Behavior

-Suicide Attempt

-Suicide ideation

4/20/15: Clt endorses SI w/plan to overdose on prescription and OTC medications. Clt reports two aborted suicide attempts earlier this evening, one in which she had 30 benedryl in her hand ready to take but decide4d not to and once she had 50 zyprexa in hand. Clt was unable to contract for safety with this writer when a crisis plan was attempted.

9/16/15: Clt endorses SI w/plan to jump from balcony or crash car. Clt reports that early today she was standing leaning over the balcony for "awhile" contemplating jumping. Clt mention s that she thought she may be able to fly and if not she was aware this would probably kill her and reports "I was ok with that as long as I didn't have to feel like this anymore".

Here is another page from my psych. medical file

Little Worlds for Little Me

One intense image to another. One moment in time to another. I could see the little world in each thing in the world. Day by day, I went through life like this. I'd get so taken in by one detail, I'd forget everything else. I had a fascination to touch everything. My grandmother on my dad's side often would call my name in a tone that meant "Stop touching!" This is how I spent my days as a child, slowly guided through the "normal world" by others. I was apt to get confused at "the real world", and preferred to stay in my own area of comfort. I didn't always understand what was being taught in school and instead preferred my own version. I got lots of "creative" compliments from teachers, when subjects like math just went over my head. As I got into the teen years, I got into early music and would listen to it for hours upon hours, my favorite being Mozart, but I quickly developed a taste for early music like Allegri's Miserere

Now, I can still get lost in these worlds, thinking so hard about them that I am not paying attention to the outside world at all- just like I did as a kid. It can be art or music, but it can also just be a piece of moss on a tree, or the way the table is set. In fact, each one of these "scenes" gives me a different emotion. Sometime they are friendly emotions but sometimes they are not and I have to redirect myself. This was not so easy as a child. Redirecting my thoughts almost never happened then. I also had times when I just could not understand what an adult was trying to say to me. This got me into trouble sometimes. Then I would feel confused and hurt. I did things differently than the other kids. For example, in Kindergarten, we made treats out of ice cream cones and frosting. I had taken a bite out of mine when nobody else had. I felt so bad that I didn't know we weren't supposed to eat them yet and that my friends somehow did know this!

What of this is mania and what is depression? I wrote in a previous entry about early psychosis. It doesn't go back this far because I can't think of any psychoses I had as a child. If I did have them, they were so real that I didn't recognize them as such. However, I did have an episode at age 4. My dad says it was brought on by some medication for my bladder (infection?) but the name and dose are long forgotten. At any rate, I woke up one night in the middle of the night hallucinating. I had a "sparkle finger" that I could make patterns with in the air. My dad and I had fun with this until "the trip went bad", as they say. I saw monsters! "Shoot them with your sparkle finger!" my dad suggested. This went on for hours- heck! all night maybe. Whether the drugs caused this or they got my pre-bipolar (pre-diagnosis) brain to do this, or it was a coincidence I don't know. It was a hallucination so I will count it here. I do not recall every being depressed during my childhood (pre-puberty).

At 10 I got a 110 camera and enjoyed taking the little worlds I'd see and making them into film form. Not the best camera ever and I was only 10, but it was the start of something I still love today.

At lunch one day in about first grade, I went to the lunchroom only to find none of my classmates there. In fact, nobody was there! I was very confused. I went outside to see if they'd gone to recess, but couldn't find them there either. When I came back in, they were at the table eating away!

In 2nd grade, I was placed in an advanced reading group. We had a plastic bubble that you attached a fan to to "blow it up" and then we'd all go inside and read. My problem was that I had no idea what they were going on about. Their language was foreign and so was the reading material. I still don't understand how I got in that group!

It wasn't until I was 16 or so that my grandmother bought me a tape of King's College Choir that I really got into choral music. Its still a favorite of mine to this day. I sometimes wonder why I never sang as a child. I played the violin and the piano, but not very well. My voice was low but not extremely so as a child. (I have recordings.) My mom says I couldn't carry a tune in a bucket back then. Our family always had music playing, but mostly instrumental as my dad played the violin. That and whatever was popular at the time- James Taylor or the like.

I still see the little worlds. I still get lost in music. I still hallucinate. Sometimes I have times when the sound is all individuals in a restaurant for example instead of "background din" and that is really hard to deal with as its overwhelming.

This was just a small glimps into little worlds for little me.

Hyper-Aware & Time Crawling

I'm home. It's dark. Inside and out. I brushed my teeth after dinner. Time crawls by. Breathing noticeable. Afraid of last time where I couldn't shut it off. I was hyper-aware of each breath. Started today with cold air activating my asthma. So much time until bedtime. One kid here, one kid not. Strange state. Indefinite. Had music on. Now off. Now on. Had a movie on. Now off. I feel stuck in this moment. Will I ever see the sun again? So much to do tomorrow- important stuff! A video to watch. Music playing Pie Jesu now. Papers to turn in to two places tomorrow. I can't believe I'll finally be off Zyprexa! My cholesterol is 700+ and my triglycerides are even more. I won't start the new med. (Rexulti) until I see my pdoc which is the first week in January. It seems so long from now- almost six weeks. We have to get through Christmas. Heck- this week is Thanksgiving! The breathing thing, let me explain. A couple years ago or so, we tried to change my medications up. We tried several different meds. One of them had the side effect that I was hyper-aware of my breathing: every breath in and out I felt. It was very distressing!! I can't even type about it without it trying to come back, so I'll just say that it started to come back today with a trigger of cold air outside (it was 27 degrees today). So today has been a day of time crawling by and of being hyper-aware of my surroundings. Please shut it off. Thank you.

A Non-Bipolar Post

So let's see. I couldn't think of anything on-topic to post so I'm taking my psych nurse's suggestion to post something not about bipolar.

For one, I did move into a 2-story apartment this past February. Its been good. Keeping it pretty clean, though with two of my three kids here its not always easy. We still get section 8, which I had to reapply for recently, too. Speaking of, I just got more paperwork in the mail to fill out. Life is paperwork! (And they said we'd all be 100% digital by now.)

Tomorrow, my younger two kids have their yearly check-ups. They have talks about their health, sexual health (which I get sent out for), and vaccinations. My daughter still refuses to have the pertussis vaccine, as she had seizures and high-pitched screaming at her first dose at 2 months old. Of course, I don't want her to have it either. Usually, we go out to eat after, but my friend is driving us this year as my car is broken and not reliable to even drive a short distance to the doctor's. My youngest has a piano lesson after the appointment so we'll see if we can get him there on time. You never know if the doctor will be running behind.

ETA: We did get my youngest to piano on time. The doctor's visit lasted two hours total, but that was for both kids and just one doctor.

The car will get taken in to a new shop soon. The first one I took it to was unable to figure out what is wrong with it!

I went to parent-teacher conferences on Thursday. My daughter (17) had all A's and one B+ (89%!). My younger son (15) had one class where he wasn't doing very well at all. However, they had all nice things to say about him in general, including that he's doing calculus in math class instead of algebra; the teacher wants to get him into college classes for math. How he can be failing one class and advanced in another, I have no idea. That's just how he is!

I ran into my eldest (19) at Starbucks today. He was getting coffee for himself and his friends. We sat and talked about his jobs and school. He's gotten a second job at the same place and is working 60 hours a week. I think its holiday hours, but for a while he'll be getting some big paychecks! I didn't recognize him at first when he walked in. I thought, "That looks like N!" No wonder it did- it WAS him. He usually goes to bed around 6 p.m. as he has to go in to work at midnight. I am going to help him sign up for Medicaid, if the office is open on Friday. (Day after Thanksgiving.) He needs to see the doctor, too, but had to cancel his appointment for tomorrow. We will get it figured out.

I tried taking a nap earlier, but I just ended up tossing and turning. Figures that when I have a length of time where I can nap, I can't! ETA for Monday: I got a nap today, complete with crazy dreams!

My friend C and I need to have a visit. I haven't seen him him in months and months. We usually get together for a weekend during the winter. We get a hotel room and go see live comedy, go bowling, go to an outdoor hot tub place, go out to eat at a nice restaurant and more. We've even watched DVDs on his laptop computer in the hotel room. We talk on the phone nearly every day during the week. We get along so well. He says we shouldn't date because then we'd fight. Maybe so. But I'm still looking forward to January when I see him next. Oh yeah- he reads this blog. Hi! ;-)

A friend of mine -and a mutual friend of mine and the friend "C" above- who is the same age as I am (44) is just entering her third trimester with her fifth child! I can't believe it still, and I've known since she was about 7 weeks. I think she overdoes it sometimes, but it hasn't seemed to have had a negative effect on the pregnancy, so I'm happy for her. She's waiting to find out if its a boy or a girl. She already has some cloth diapers and clothes. All her clothes and diapers from her other kids are long gone, as the youngest is 17. I wish we lived closer. I'm just glad its not me. I had two high-risk pregnancies (first was textbook). After that, I didn't want to chance premature labor again, so I finally had my tubes "tied". (Actually, I had the Essure procedure done.) My next stop is peri-menopause, if I'm not there already. In another 10 years I should be there for sure, if not menopause.

My youngest son had a piano recital this afternoon. I couldn't go because of my car being out of commission, but I saw this video. (Video link doesn't work right now for some reason.) He plays this all the time at home, no wonder he was good at it! In fact, I'm usually telling him to stop playing it. (Because I'm usually on the computer two feet away from the piano. Oh well. You know I'll miss it when he's grown and gone!!)

Rexulti

I saw my psych nurse (pdoc/psychiatrist/nurse practitioner) today. Everything seems well. I told her about the angels and the rodents. About three hours later, though, she called. I was out to lunch with some friends and didn't hear the phone. She left me a message that said that as my cholesterol and triglycerides are so extremely high (700+ from what I saw at my primary doctor's office) from the Zyprexa she wants to try me on another atypical anti-psychotic that's new- Rexulti (Brexpiprazole). Its brand new (since July 2015) and is related to Abilify. I did try Abilify several years ago and had some sort of reaction to it- what it is escapes me now. It may have been akathisia. The other issue with this new drug is that it interacts with my anti-depressant Wellbutrin (Bupropion) which I started relatively recently, too. It didn't say to never use the two together, but to keep a close watch over side effects if you do. I am hoping I can stay on Wellbutrin because it really agrees with me and I with it. I've felt better since starting it- and didn't even know I felt poorly! I liken it to getting glasses for the first time: everything is clearer than you ever thought it could be! I also have read that this is an expensive drug- so much so that one person's psychiatric hospital removed Rexulti from their medication regimen! I know that some of my medications are over a thousand dollars a month, so I would hope that if this drug works out for me in terms of (lack of) side effects and positive benefits, that they will pay for the pills. I did call my nurse practitioner back, and the best I got was someone else said they'd leave a note on her desk saying I was trying to get ahold of her. She doesn't want me to start taking this until after the new year, for some reason, so I have quite a bit of time, and in fact, I think I see her before or just about that same time- the turn of the new year. She also thinks that this drug will be a better over-all fit in terms of side effects (or lack of). From what I've read, too, its marketed toward people with schizophrenia and major depression. I haven't seen any mention of patients with bipolar disorder. This would be an anti-psychotic- an "atypical" type. Older types, like Haldol, tend to have more side effects. However, some people try them and have great success typical anti-psychotics. For me, I think I'd get all the side effects. Two years ago, when my psych nurse and I tried me on several new anti-psychotics, I had lots of side effects. I'm hoping that won't happen this time. I did read that there's a rare side effect called neuroleptic malignancy syndrome which is fatal. It usually happens during the first few weeks of taking the drug. Its a tad more common when combined with lithium, which I take. Oh! And my psych nurse practitioner told me that I should add something other than when I'm having an episode to this blog. I don't think she's read it, though. I must've mentioned it. I add things that aren't directly related to bipolar if they fill out the story I'm telling, or how I'm feeling. Like right now, I'm listening to some scrumptious choral music. And I brought home my music from church choir to practice as I didn't "get" a few clumps of measures yesterday. I'm losing my edge! Me? Have to practice outside of rehearsal? Say it ain't so!

Social Security Disability

I was driving the car when the phone rang. I answered it. The voice on the other end said he was from social security and I had been approved to disability! My first time applying and was approved! No appeals, nothing. I am so happy with my lawyer who helped me and with the judge which I sat in front of last summer. I thought it all went well last summer but you never can tell. My lawyer thought it went well, too. So the man who called asked me many questions to confirm I was really me and information about my bank account so funds could be direct deposited. He wanted to know historical information on where I've lived and and other money-type questions. The way we left it, I seem to be getting a deposit this Friday (in 3 days). The only issue was that he thought there was an "89" attached to my bank account number. He was confused about it. I said I never add an "89" when I input my bank account number. He said he'd call the credit union I use and call me back if there was still a problem. He never called back so I assume all is well. I'm so happy that I should be able to pay my bills more easily. But as I said, I know I have to report this income to DHS (Department of Human Services) so they can adjust my DBT card ("foodstamps") amount. I hope it doesn't kick me out of Medicaid as I need that for all the appointments I go to, both for mental health and regular doctor's appointments.

No More Angels in the Garden

Sunday at church we had an extra service: a memorial service for a choir member's father. The choir sang a favorite piece of mine Like as a Hart by Herbert Howells. We had an entire service complete with communion (our second for the day). Afterward, we walked out to the garden. The garden where I saw the angels. People were arranged just about the same as the previous week with the clergy in the center on the grass, the congregation at the back near the wrought iron gate and the choir under the ceiling next to the grass. People scooped dirt into a small hole in the ground. This time, everything was in clear definition, each person in their perfect place; each plant in the garden crisp and green and the leaves on the tree, autumn red. I looked, but there were no angels to be found. Ah! Zyprexa, yup that's what you do and you do it so well. I will never forget those angels. Zyprexa can't take that away.

The sleepiness is still with me from the new dose, but I think I'll get used to it. I was on this dose in the past, in fact, and did fine. My psych dr's nurse called today and said they called in a script for 15mg. The doctors at the hospital lowered it to 10 mg when I was there in September this year.

Zyprexa Dose / Soothing Music / Confiding Bipolar/ Advent Music

The hallucinations seem to have calmed down today for the most part. However, the higher Zyprexa dose is making me feel like I'm swimming in syrup. Just turning my head, my body follows, everything feels very heavy and I feel as though I'll topple over. I've wanted a nap all day since taking the pills, but I was out with friends and couldn't and now its a bit too late in the day to sleep, if I really don't have to. I've tried to read some things online and its difficult to follow the lines of text.

I am listening to the Peter Schreier recording right now and its soothing. I've given up on Facebook for quiet a while- until every other post isn't about the election. I don't need that stress. If I really need to know something, my friends will tell me. One of my Facebook friends said, "Does that mean you won't be on Facebook for four to eight years?" Could be! - If people don't get back to their normal posts.

I confided in a fellow alto in choir about being bipolar, last night. She said, "Oh! That's my specialty!" I didn't get a chance to ask what, exactly, is her specialty, but maybe I'll ask her on Sunday. In rehearsal, we got some early Advent music some of which I've heard but never sung- especially the alto part!- so this should be fun.

Day after Election & Hallucinations

Its the day after the election. What a night(mare). People everywhere are very afraid. I am, too, but at least I slept. Noah kept waking me up with updates.

This morning, I keep seeing a mouse. Once, it ran under the door. I don't think it was a real mouse; it was a bit blurry and didn't make any noise.

I also heard voices while in the shower and then again downstairs. They were very clearly projected but I couldn't understand what they said.

I have a virus the nurse said- body aches, run down, fatigue, runny nose. I felt like I was an idiot for calling. Stupid nurse.

Today, I'm going out for coffee with my friend so he can discover just how badly the stock market got hit since yesterday. All because of The Orange Cheeto. (*Edit: The stock market was pretty okay. Don't ask me!)

I got some new jeans and they are so comfy. Yay for losing weight!

I'm back on all my meds now and I got some refills. I'll need more on my psych drugs in a week when I see my psych nurse again.

Oh and I just saw what I thought was a still photo on Facebook when the baby began to blink his eye over and over. Then he moved his head!

I called my psych nurse practitioner. She prescribed adding half again what I'm taking in Zyprexa, so that's a total of 15, or 1 1/2 pills. The goal is to get the hallucinations to disappear. Now can it take away this dread I feel about the election results?

Editing 11/10/16 to add that yes the higher dose of Zyprexa has zoned me out. I sat in Starbucks for several hours drinking decaf and looking at my phone. I'm still seeing some hallucinations. This was supposed to be today and tomorrow for the new dose, but the psych dr office isn't open tomorrow so I have to call them today. I was just sort of staring out the window and when I was looking at Facebook and my bipolar bulletin board, it was blurry to read.

Angel Visions

Do you believe in angels?

I think I sensed and saw some on Sunday. They were big and there were several.

We were outside at St. Andrews church. Nobody else saw them but me. There were clergy members, some of the congregation and the entire choir.

Who knew angels were so big? Immense is a better word. Larger-than-life and gender-less. These had wings. They were a presence among us, as if they were in another plane on top of our reality, but clear as day. There were three or four of them over by the pointy iron gate around the garden among and in front of the congregation members who were hanging behind the gate.

As choir members, we were singing chants in a call-and-response fashion under the overhang over the sidewalk next to the grass. The congregation was still behind the gate that surrounded the garden the clergy was in. The clergy was reading names and swinging incense in the grass of the garden itself.

As the choir was singing, standing there in our black cassocks and white albs, I stopped and was quiet as my friends continued around me. I wondered if any of my friends could see these huge creatures. They were oblivious.

The names had all been read and the chant was over, so we concluded the service, walking back inside the sanctuary to gather our music and books.

Early Psychosis (Pre-Diagnosis)

They say you don't get diagnosed with bipolar for at least ten years after symptoms first show up. In my case, it was more like fifteen.

When I was a teenager, I'd hear voices call for me, while I lay in my bed in the middle of the night. I thought it was my sister whose room was right next door, so I'd get up to go see what she wanted. She was asleep. If I woke her up, she'd be confused and wonder what I was up to.

At about twenty, I had my wisdom teeth removed. I stayed at my mom and dad's place with my dad as my mom was out of town on business. After the surgery, I was home on Vicodin, or something similar; I always thought what I'm about to describe was to do with that, but now I'm convinced its not. In fact, I asked my friend who is a behavioral pharmacologist if pain meds can cause this sort of thing (hallucinations) and he said "Not a normal dose in someone without bp*." The condo my parents lived in was built into a hill so that the back of the living room was higher from the ground than the front and front door. The balcony with sliding glass doors was at the back on the second level. One day, I saw aliens standing at the doors, knocking for me to let them in. I did not. They were short and pleading. They didn't say anything, and in fact, were completely quiet except for their sotto voce knocking. Later that same week, I was in the basement. There were no curtains, so that the black of the nighttime filled the windows and the sliding-glass door. I knew that the black was coming to get me. The oneness of it consumed it. Somehow, my mom called (pre cell phones) and I told her of my fear about the black. She said, "The black can't come get you," "I know!" I agreed, "but its coming anyway." She suggested that I maybe had had too much of my pain medication. It sounded plausible at the time.

Around the time when my daughter was born in 1999, I was in the bathroom looking out the window into the back yard. I saw many very large orange rectangles in the sky. I checked if they were really there by looking back in the bathroom and out again. Yup: Every time I looked outside they were there, but inside they were not. I called my husband to come look. He did and said there were no rectangles in the sky. I don't remember how long they took to not be there anymore, but my doctor was not called. I recall taking Zoloft around this time, so I must've had a psychiatrist. Again, I didn't relay my experiences.

In early 2001 when my youngest son was born, I had some vivid visions. When I was giving my daughter- then 2- a shower, my hands would crush her head- blood, broken bones, warped skull! It was as if it had really happened. I'd gasp! I went on with the shower, but it kept happening over and over. I did call my psychiatrist about it at the time, but she still said I had post-partum depression and kept me on my anti-depressant. I am thinking this was post-partum psychosis, not depression, but my doctor did not agree. Around that same time, I also had visions of driving my car into the opposite lane of traffic with the kids in the car. I got picked up and stayed at my sister's apartment for a while. I did call my psychiatrist that time and she said to stay put and not go anywhere. Aside from this last bit, I still don't think my case was managed very well at the time, especially since my psychiatrist was big into post-partum depression: she had many patients with it and had written books about it; therefore, in my case, I think that's all she could see. My OB/GYN, on the other hand, warned me and my sister about psychosis after birth, telling us to tell her if we got any symptoms that were even sort of like psychosis. This was when I woman named Andrea Yeats had drowned her five children during the post-partum period.

About four years later, I was taking my youngest to preschool and was walking the halls when I saw vivid spines being ripped out of the children at the school- body parts flying against the walls and blood splattered over the floors. I managed to call my psychiatrist, who said, "Don't drive!" and prescribed me Celexa. This was when I was in my early 30's. So close to being diagnosed (about age 33) but yet so far. The Celexa didn't do much to calm the psychosis and in fact, I went driving to Wendy's that day and was very confused about where I was and what I was doing. No anti-psychotics were added. In their minds, I still must've had post-partum depression? How could that be when my youngest was four? In all those years, what were they thinking? How could they STILL not diagnose me as bipolar? My parents didn't see it. But today, its so plain to see.

*bipolar