Tag Archives: paranoia

Like a Fish Out of Water; Surgery and the Hospital Outside the Psych Ward

Well, it’s happened. I’ve made it through my hysterectomy slash bowel-resection surgery and in hindsight it appears that having an exploratory surgery a month previous to this one gave both my doctors and myself the opportunity to work all the kinks out before tackling the more serious subject of my bowel being invaded by endometrial tissue.

The two weeks leading up to surgery were torturous and the overwhelming amount of anxiety I was feeling about the aftermath led me to skirt around the fringes of paranoia when it began to escalate.

Generally for me, paranoia tends to take the form of the belief that someone is trying to kill and/or undermine me in some way. My paranoia stemmed not from the surgery itself but from the 5-7 days I was expected to spend in the hospital recovering after surgery.

I had never spent time in a hospital –that is to say, I have never spent time in the hospital, save the psychiatric ward. Trying to fend for myself in a psychiatric ward (and by that I mean communicate properly with my doctors and nurses about my particular medication sensitivities and the odd tendencies of some of my psychiatric symptoms) has often led to both a communication breakdown and further exacerbation of whatever unfortunate mental state that landed me there in the first place. This is an issue I’ve had with many regular doctors as well, so the idea of being drugged (or asleep) in a hospital bed and at the mercy of whoever was on duty that shift frankly scared the hell out of me.

To offset my crippling fear of facing (another) abusive nurse or another medication slip up (as happened with my last surgery) I spent the week leading up to surgery generally huddled in my apartment making list after list of instructions, drugs to avoid, people to contact in the event of psychosis or mania induced by medications, etc. followed by lists about each of the lists, color coded and copied several times over to be available on my bedside table.

Though I found this slightly soothing, there was still an extraordinary amount of fear. What would happen if I had to share a hospital room with a stranger? Would my PTSD land me in a situation where I became manic or psychotic -as it has several times in the past? And what about if I did become manic or psychotic, how would the hospital staff respond to that? The hospital I was to have surgery at doesn’t have a psychiatric unit, so I was baffled at what might take place if I needed one.

A touchy subject for me, given my history of difficult hospitalizations and abuse in hospitals. Thankfully it was not one I needed to explore, because after speaking at length with my surgeons and anesthesia team on surgery day we made a quick decision that allowed me to bypass the use of narcotic pain killers almost entirely. I opted instead to receive an epidural, which numbed my body from my waist to my knees, rendering the use of the narcotics (that have proven to be big time triggers for me in the past) unnecessary.

So not only was I not triggered by the narcotics, I did not require much medication for nausea (also a trigger for me) since I was without the narcotics. I was able to be put in a private room (given my mental health history and luck regarding room availability) and since I only had to take a small fraction of the drugs I would have otherwise, I was generally alert and able to communicate with the staff more easily regarding my drug allergies and (psych) medication needs. My alertness definitely helped ease my concerns in the area of paranoia… though I did wake up once or twice in the middle of the night certain that the balloons next to my bed were up to no good.

Actually, the bigger problem (in terms of my mental health) in the hospital was the fact that my vitals were being taken every hour over night, so I was not able to get more than 45-50 minutes of sleep at a time. Sleep disruption can also be a trigger for me (both in terms of mania and depression) so I opted to get home from the hospital as soon as humanly possible.

Generally speaking, the staff in the regular part of the hospital were much more kind and eager to listen than those I have met in the psych wards in the hospitals I have been to. I feel very lucky that they treated me respectfully and did not discount my concerns merely because I have a mental illness, something that unfortunately is a serious issue in many psychiatric units today.

I definitely can’t say that I went the four days in the hospital without any mood swings at all, but they were generally depressive waves… much more easily managed laying around in a bed all day than mania. In the last week I’ve been home they have definitely been increasing in frequency and severity, but I am hopeful that being able to finally diversify my meals a little bit and spending more time without intense pain (rather than with it) will help tip the emotional scales back in my favor.

All in all, I would say that the surgery and hospital time went better than I expected. There were no incidences with bad medication reactions, or particularly volatile interactions with the staff (ok, maybe one), and it felt like a totally different experience when my doctors made everyone else adhere to my psychiatric and physical particulars.

The difference this time around surely came from one of my surgeons having had a foster daughter with bipolar disorder. He has a first hand experience seeing the sorts of episodes and behavior that can be triggered (for me at least) by many medications, among other things, and there is no doubt in my mind that this led to him directly telling the staff to take my concerns very seriously. Frankly, he seemed just as concerned about triggering me as I was, which is how I imagine (in a perfect world) healthcare professionals should act!

Anyway, I am glad to be home.

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More Rest, More… Butter?

Very quick update.

Please do not be offended if I do not answer your calls, texts, or emails in the next few days. Between the physical illness I’ve been having and intense insomnia I have stumbled into a place of extreme irritability, confusion, delusion, and paranoia.

Yesterday I shampooed my hair three times because I couldn’t figure out which bottle was which. I also snapped at my poor old granny on the phone, which is why I am instigating a period of Sarah-radio-silence until I can talk like a civilized human being to people again. Or, at least, civilized-ish.

On the upside, after some really fun biopsies of my stomach lining I do not have celiac disease (thanks doc!), I have finally slept four hours in a row (thanks benadryl!), I’ve been enjoying a John Cusack movie marathon, and I ate 1/8 teaspoon of butter this morning on an otherwise very dry bagel (weee!). This is huge progress (especially since I spent a big chunk of time earlier this week doing more vomiting) and I hope it means I will soon be able to stop putting olive oil and salt on my noodles and eating with my eyes closed pretending it is butter.

Once I get better at the not-hating-everyone bit I should hopefully be on my way to recovery on all fronts (well, that and once intestinal infection is ruled out). Usually the emotional instability part takes a bit longer to catch up, but who knows… maybe if I drink enough smoothies I’ll start to feel peppier.

Still Waiting for an SSDI Decision

After the SSDI hearing in February (but pre post-hearing mental breakdown) my attorney told me to expect a letter in the mail with a decision in 3-5 weeks.

In the midst of the intensely depressed meltdown that followed, I checked the mail each day (some days twice) in hopes of hearing something. Every day since February 13th I have put my mail key in the mailbox and experienced a panic attack being triggered. The faster I put the key in and open it before closing it again, the more quickly the panic attack ends.

This has been the routine every day (except Sundays, and as I mentioned, some days twice because the mail didn’t come on time) for nine weeks now.

The intense depression dissipated. The notion that my life would end if I wasn’t awarded SSDI has passed. I’ve formulated a new future in my mind, a future where I don’t have the things that I wanted… and that is ok with me now. I know that leaving my home and having to find a new one farther away from the city is part of that future, but in the last couple weeks (without the depression) it doesn’t feel like the burden it felt like before.

I am no stranger to a sense of paranoia, of distrust, and I admit I was beginning to become suspicious of my mailman. After all, he works so inconsistently… what if he lost my decision letter? What if he was sitting in his little white hatch-back eating fried chicken reading it? I know. But that is where my mind goes!

Two weeks ago someone (Corey? A friend? My sister? I don’t recall) suggested I call my attorney’s office to see if they had any news. I agreed this was a great idea, but was so hypomanic all this time the days kept slipping past, faster and faster, and I forgot (several times).

When I made up my mind to call the office, I couldn’t remember the name of my case worker. Once I remembered it, I couldn’t remember if I was remembering it correctly, and my fear of phone calls was compounded by the thought that I would call the office and ask for someone that didn’t exist.

I finally made the call on Wednesday. The name I remembered was the right name, but the case worker said it isn’t uncommon for the decision to take this long, if not longer. 

The words she said rung in my ears:

“They haven’t made a decision yet.”

As much as I want to know the conclusion of all this fun I can’t help but feel pleased with the fact that there is still some element of mystery. Mystery in the sense that if they want to approve my claim, take your time! On the other hand, if you want to deny it, do it as soon as humanly possible.

At any rate, I’ve been waiting to go into more detail about the hearing until I received my decision letter… which of course I thought would be sooner rather than later. At this point, if the deep contemplation going on over there has things leaning in any way in my favor, take nine more weeks. I really don’t mind.

Don’t Step On A Crack…

So I’ve been somewhat m.i.a. after hurting my back late last week. I’ve only ever hurt my back once before (trying to pick up a five gallon glass carboy full of fermenting homebrew wine a year or two ago) and that time I immediately knew the error of my ways.

This time all I was doing was washing my hair and all hell broke loose. The funny thing was that I began having spasms on one side of my back, but they stopped after a few minutes. Then, hours later, they began again on the other side, twice as intense.

Thursday began a dance of two steps forward, one step back… lying in weird positions, surrounding myself with pillows, hot packs, cold packs, and eating a lot of cookies.

This might not have been such a big deal, but Corey was working on a film competition so he wasn’t home.

Out of all of this, the pain was pretty bad. Not being able to sleep was even worse, but what scared me the most was what effect this situation might have on my mood.

Up to the point of wrenching my back, I had been experiencing some pretty significant depression with massive negative thoughts and urges. By some miraculous twist of fate, the first two or three days my back was out of whack my mood was… well, fine. Even being alone didn’t seem like a big deal, which was unusual for me.

Then, Saturday night happened. I had barely slept in days, and beyond my pain and exhaustion crept an increasingly intense feeling of paranoia. By the time I was able to get into bed (a generally safe feeling place) I was met with audible hallucinations.

I admit, I was expecting some sort of rebound depression from the pain I was in the and from the sleep I wasn’t getting, but I wasn’t exactly expecting full-on psychosis.

My back is doing quite a bit better (though sitting in this chair typing is a bit uncomfortable) and my mood has switched back to an alternating I’m fine / now I’m desperate and crying on the bus pattern. Laughing one minute, crying the next.

This week I’m meeting with my psychiatrist, so I’ll keep  you posted on what happens (though I’m pretty certain of what course of action I want to take at this point).

I’m Singing, Just Singing in the Pain

At what point does childhood fear cross over into full fledged paranoia?

I’ve recently been getting a little flack for how much I sing out loud. And I don’t mean when the radio is on in the car, but around the house doing regular, household things. My boyfriend was quick to blame the role that Disney played in my childhood for this, and I laughed and agreed and shrugged it off.

But… I’ve been thinking about it more, particularly at night when I’m walking home from the bus stop and it is dark and silent outside, and I realized that moments like that one remind me of my childhood.

I had a lot of anxiety as a child (though I didn’t know it until a very long time later), and that is one of the places the obsessive compulsive “tendencies” I have really began to flourish.

I wasn’t afraid of the dark, but I was afraid there was something in the dark. And it was always going to “get” me. Sounds perfectly natural for a child, but at what point does that become better described as paranoia? 10 years old? 13 years old? 15 years old?

Anyway, as a kid, the best thing I could think of to combat this fear (which I’m sure was actually passed to me by some character on a show, maybe Grover?) was to sing.

As long as I was singing, I was untouchable.

To a large extent today, singing is an important tool for me.

I mean, I’m no pop star or anything, but even just something a step above a hum seems to help immensely when it comes to facing things like excruciating racing thoughts, delusions, and intense paranoia.

My theory as to why this works is two fold.

First, singing aloud is something that requires confidence. Like I said, it isn’t as if I’m a particularly good singer, but I do it anyhow. Singing requires confidence, singly poorly probably doubly so! The confidence I have to tap into when I sing out loud isn’t allocated to the singing alone, once I’ve tapped into it a little bit of confidence goes a long way.

It takes the edge off the fear.

My thought that this has to do with confidence came from the fact I get some of the same relief from activities like dancing (which, again, requires some degree of confidence) and even doing silly things, like practicing a fashion runway walk. If I can muster enough courage to do any of those things, it will carry me through a dark place of fear into a lighter one.

And second, it gets me out of my head.

Singing aloud requires concentration. If I am actively thinking about hitting notes or what the lyrics are, I am not thinking about how terrified I am. You’d be amazed at how much not dwelling on a specific series of thoughts can help in ignoring the fear.

This is also why I said singing aloud is great for racing thoughts as well.

I think the idea of the mantra (a sacred word or syllable used as an object of concentration or embodiment of spiritual power) acts in something of the same way. By focusing on repeating a word or sound aloud, it frees up your mind from dwelling on many different kinds of thoughts -in this case for activities like meditation and yoga.

My personal version of a mantra is the chicken dance song. I know it might sound a little ludicrous, but when things start to get out of control in my head, I sing that annoying, chicken dance song aloud. It has no lyrics, so really I’m just repeating a set of sounds over and over again, and the result is that I can remove myself from whatever gobledigook is going on in my mind.

Music has always acted as a great outlet for me, and that is one of the biggest reasons I miss having a piano. Having a piano just gave me further excuse to sing aloud, with the added bonus of being able to focus on playing the music myself at the same time.

Anyway, this may seem like a childish notion, but it has really remained relevant through my adult life as well.