Archive for April, 2013

Graded Exposure and Emotions

27 Apr

On Thursday I met with my care coordinator (cc) to begin a program of graded exposure. This basically means that in order to build up my confidence in going out in public in the day, we were going to start doing exactly that.

My cc thought that I had too many psychological blocks on going out near me and so we decided to meet in a local park’s car park when we thought it would be relatively quiet. The plan was to see how I was and maybe go for a walk around the park.

It didn’t quite go to plan. By the time Thursday came along I’d turned myself into a nervous wreck. I hadn’t slept at all the previous night and felt close to calling the whole thing off, but I didn’t. I met with her and we essentially spent 45 mins stood next to my car as I was too on edge to move any further. I spent the whole time looking around and making sure I knew where everything was, and if any people (thankfully few) came along, I followed their every move to make sure I was ok.

By the time I got home I was drained, both mentally and physically and wanted nothing more than to sleep, but the adrenalin had kicked in and that was the last thing my body allowed me to do. I was positive though, it was a step forward, a very small one, but in the right direction and my cc had been pleased with me for the amount of time we managed.

That night I thought I’d sleep, but again it felt like my body was on high alert and wouldn’t let me relax enough to close my eyes. I could kind of understand this, but I didn’t expect it to last as long as it did. In the night I had a huge wobble. I cried, a lot! I wondered if this was it, was this all I was going to be capable of? Standing by my car for 45 mins and then spending the next 24 hours recovering from it!

On Friday I decided I needed to be kind to myself. In my old life getting so worked up over something so tiny would have been pathetic, but this isn’t my old life and what I did wasn’t tiny. So I spent the day watching tv and snuggled under my duvet (not in bed though!).

And then today hit. In PTSD, anger is one of the symptoms and I’ve seen flashes of that in me and I really don’t like it. However, it’s one of the things I do keep in check for the majority of the time. But today, I’ve got this deep down, in the stomach, kind of burning anger. I can’t really describe it better than that. I’ve kept away from people on purpose as I know I’d lose it at the tiniest of things. As the day has gone on, I’ve tried all my known strategies and yet still I feel very much on the edge – this is something new!

And so it begs the question; why have all these emotions come to the fore? Is it because I’m trying to move forward and this is bound to happen? Am I finally feeling anger because of what I went through or is it anger at not being the ‘old’ me and not being able to do the simplest of tasks? I’m not too sure at the moment but I don’t like this side of me one bit!


Dissociation and PTSD

07 Apr

I have just come out of hospital after spending 3 days in there. The reason why is a bit more complicated so let me explain!

If you have been reading my blog, you will see that I have been under the home treatment team (old crisis team) after having a particularly bad month. I have been working with them and seeing them every other day and whilst I was having high suicidal thoughts, we were managing them quite effectively.

It started for me on easter week, when I felt like I had been losing time and when they asked me questions about what I had been doing, I honestly couldn’t remember. Have you ever felt like when you’ve gone in to a room for something and for the life of you, you can;t recall why? Well it’s that kind of feeling – no matter how hard I tried to remember, I couldn’t! They told me it was because I wasn’t doing anything in my days and so everything was just merging in to one. I didn’t really feel like it was for this but just left it as nothing anyone could do anyway.

In the past when I’ve had very bad times, I have dissociated and actually thought it was a time before my trauma and didn’t even recognise my care co-ordinator. However, she has always been ok with this as it meant I was ok – it was pre-trauma and so I was happy!

On Tuesday night, I went to bed at about midnight and the next thing I remember is it was 2 hours later and I was ‘waking’ up at the side of a local reservoir with an empty bottle of my medication. At first, I thought I was dreaming but after realising I wasn’t, I panicked! I wasn’t suicidal, I didn’t want to take too much – why had I done this without knowing it?

I called NHS Direct and tried to explain what had happened. I wasn’t aware of the effects of taking the amount I had done and didn’t want to drive home if there was a chance I could hurt someone. They told me they were sending an ambulance to where I was, but I didn’t want to waste resources and so said it’d be quicker for me to make my own way there.

I arrived at accident and emergency and was seen by triage. She took my ob’s (blood pressure, heart rate and oxygen levels) and picked up the phone and asked if they had a bay for me. I thought it was just in the normal bit but she told me I had to go straight to resus. My heart rate was tachycardic at 155 beats per minute (the normal is between 60-80). I was hooked up to a heart monitor and had an ECG and was really well looked after. After a few hours I was moved to the Medical Assessment Unit (MAU) where a doctor eventually came to see me – this was now Wednesday evening. He told me they still needed to keep me in and redo an ECG over night and hopefully discharge me on ward rounds the next morning.

At about 11.30pm they moved me up to an escalation ward. This is essentially a place they open when it is busy and use it to keep people who are close to discharge. For this reason, it is trollies and not beds that are there (it’s a day surgery unit). There is a 23 hour rile that you aren’t allowed to be on them for longer than this timeframe.

The next morning, the ward round happened and I hadn’t had another ECG so the doctor ordered it again. It was still high – 110 and so they said to have it repeated in the afternoon and go from there. It had gone up to 111.

I spoke to the doctor and asked if I could self discharge as I felt ok. I explained that I had PTSD and that being in the hospital where I was extremely anxious meant that they were never going to get a heart rate below 80. She agreed that as long as it was below 100 I could go. She said it was extremely risky that I leave and we agreed I’d stay another night and be checked the next morning. I was to be moved to a ward and given a proper bed. I was given a bed twice and each time when the nurse called to do a handover they were told it had been given to someone else and so I was told I’d be staying where I was. I asked what about the 23 hour rule and she said there was nothing that could be done. This is what I was on:

hospital trolley

I understand they have to make difficult bed decisions, but no one came to speak to me to explain this and just swept it under the carpet. There were 2 empty beds opposite me on the same ward and were eventually taken by one woman who had severe constipation and one who was withdrawing from alcohol. If mine wasn’t based on a mental health problem, would I still have been just left? I honestly don’t know the answer but it did cross my mind! I wasn’t even supposed to know about the 23 hour rule, it was only because I was speaking to the nurse on the night shift and she told me don’t worry they can’t keep you on there for longer than that.

The next morning, the doctor (who I had seen the previous day) came in and I heard her say, “what on earth is x still doing here?” She was excellent and saw me straight away and had my heart rate taken – it was 95, yay – I could go home!! Well that was after I had been referred for a psych review. 5 hours later I was seen and it was obvious it wasn’t intentional on my part and so they discharged me to see the home treatment team (htt) the next day (I was still under them anyway). All in all I was on the trolley for 39 hours!!

I am seeing my care coordinator tomorrow and will be discussing what happened but the htt said they had discussed it and think I had fallen asleep, had a nightmare and woken up in a dissociated state where suicide was the only answer. This has scared me – it’s hard enough to control those thoughts when I am aware of them, nevermind when I’m not!!