Tuesday, January 21, 2014

My Recent Hospitalization (Part 3)

I previously wrote about my recent visit to the Psychiatric Unit of the hospital. I wrote two posts. The first about what led me to go the hospital (My Recent Hospitalization (Part 1)). The second about the ER visit at Saint Joseph’s Medical Center (SJMC) prior to my psychiatric hospitalization (My Recent Hospitalization (Part 2)). Now about my experience on One West (the psychiatric unit at SJMC).  I want to start off by saying it was an overwhelmingly positive experience from beginning to end. I did a lot of journaling about my experiences each day I was there. The Nurses were just incredible and caring, the Psychiatrists were informed and detail oriented, the unit atmosphere was welcoming, the Social Worker was kind and compassionate, the Occupational Therapists were incredible. Overall, it was a kind, caring, and compassionate atmosphere. Exactly the way it should be for someone dealing with a psychiatric issue. I am so grateful to have gotten a bed on this incredible unit.

I arrived on the unit late Friday night (12/20/13). It was sometime after 11pm. I did my intake with a fantastic nurse named David, who turned out to be my nurse on a number of shifts throughout my stay. I was then given my medication and I passed out for the night pretty quickly. It had been a tiring day. I was woken up very early for a blood draw and for my vitals. Vitals were done bright and early every morning! I had my blood drawn a few times over the course of my stay.  The first thing I did after the blood draw and vitals that first morning was call my parents then went right back to bed. It was bright and early and I wanted to catch them before they went to the grocery store. I had found out the night before that I was allowed to have outside snacks brought in and I could keep them in my room. I was very excited about that! I wasn’t expecting that as that was not the case when I was at Sheppard Pratt 9 years ago. I made sure to jump on this and let my parents know to bring me snacks during visiting hours that day. They brought me tons of snacks and some Gatorade! I asked for Gatorade because the bottles had to be plastic and no cans were allowed. I don’t really care for bottled soda so Gatorade it was.

I was quite glad to learn that the weekend schedule only consisted of 1 less group than the weekday schedule and that I would see a Psychiatrist every day I was there, weekends included. This gave me more confidence about what the quality of my stay would be. Part way through the first group of the day on Saturday morning, I met with Dr. Haerian who had treated me in his private practice when I was a teenager. I hadn’t remembered too much about him except that I had a hard time understanding his accent when I was younger (much better now). He did however remember me, many years later. After taking a brief history and discussing my symptoms he decided to take me off of Seroquel and switch me onto Latuda. Latuda is a new medication, approved for treating depression in individuals with Bipolar Disorder who are unable to take anti-depressants like myself. The reason I can’t take anti-depressants is because they kick me into full-blown mania! Aaaahhh! I expressed to Dr. Haerian my desire to find a new Psychiatrist prior to my discharge. I explained to him that I did not feel confident in my current doctor and Dr. Haerian agreed the hospital would assist with this. The following day when I met with him he offered to be my outpatient Psychiatrist at his private practice. I was so grateful for this offer and definitely took him up on it. Throughout my time in the hospital he monitored my lithium level, started me on and increased my Latuda, and decreased my Seroquel. Slowly the depression began to dissipate. I was extremely impressed with him and am so happy to have him as my new doctor.

One West is an all voluntary unit. No one is placed there on an involuntary hold; every patient on the unit has voluntarily signed themselves in. I’m not sure if that is the reason that it didn’t feel as strict as Sheppard Pratt or if it is just run better with better staff. For one, the warmth that was exuded by the nurses on One West far surpassed any warmth I felt at Sheppard Pratt. I honestly don’t recall feeling truly cared about at Sheppard Pratt. On One West, every nurse was there because they wanted to be there not just because it was a job. They were there because they care about the patients. I felt welcomed on the unit as soon as I arrived. The other patients were all very caring and welcoming as well. I won’t speak in detail about them for their own privacy but I had many heartwarming conversations with other patients. Everyone really seemed to care about the well being of each oter. There were a number of patients there for Electro Convulsive Therapy (ECT); some that had been there for as long as a month. They had seen many other patients come and go but despite their long stays they seemed to maintain positivity as ECT helped them feel “normal” again. I learned during my stay that many individuals are sent to One West for ECT because SJMC performs ECT on their grounds. (I will write a blog in the near future about ECT because I know not everyone is familiar with it)

While I was there I spent my days in groups, writing, doing word searches, doing puzzles, chatting with the other patients, and counting down the hours and minutes and seconds until VISITING HOURS! On a psychiatric unit visiting hours are much stricter than on a medical hospital unit. Visiting hours on the weekends and holidays were from 3pm-5pm and 6:30pm-8:30pm. On weekdays visiting hours were only from 6:30pm-8:30pm. You were only allowed 3 visitors at a time and no one under 14 was allowed to visit without permission from your doctor and. Of course, that wasn’t a problem for me since I don’t have any children but a few people on the unit weren’t able to see their young children often.  I’m sure that must have been hard on them but it is surely not an ideal place for children. Everyone seemed able to see their children for Christmas Eve and Christmas. That was nice to see. I didn’t have too many visitors but I had visitors everyday, mostly my parents. The second day I was there, I had mentioned to my parents that a word search book would be nice to have to help take up some of the time I wasn’t in groups. My dad left, went to the gift shop and returned with two activity books. They really did help pass the time. My sister brought me a Greek salad on Christmas Eve and it was the best Greek salad of my life. I was so pleased to be eating that for dinner, instead of the tray of hospital food I had been used to eating. However, the food was not awful there and I was able to choose my meals, which was a relief.

The groups took up a good bit of my time. There were 3 groups on the weekends and holidays. One of the groups was an hour and a half and the other two were an hour. On the weekdays there were 4 one hour-long groups. The groups were on various topics. Every morning there was Occupational Therapy Task Group. That was my favorite because it was very hands on. There were a variety of tasks to choose from. I always chose some sort of arts and crafts activity. I joked that I felt like a 5 year old showing my parents my art work. All jokes aside, arts and crafts are very therapeutic. The other groups were typically more thought provoking. They had more to do with thoughts, feelings, behaviors, mental illness, and so on. Groups were optional but I always attended them. I wanted to get as much out of my stay as possible. Sometimes I would lie down to rest in between groups but for the most part I stayed up from breakfast on. I slept really well in the hospital. I’m not sure what I have to owe that to but I am surely not complaining. I expected to sleep terribly so it was a pleasant surprise.

Overall I would say this was an incredibly successful hospital stay. I would give Saint Joseph’s Medical Center and A+ from the ER to the unit, the nurses to the doctors and everyone in between! Everyone was incredible! I left with a new Psychiatrist, a med change that was already starting to make me feel better, a better outlook, some goals, and a call in for an appointment with a therapist. I was discharged on Christmas day and was able to have the traditional Chinese dinner with my parents! Hey, that’s what us Jews do on Christmas! 

I will do one more post in the near future about how things have been for me since being discharged from the hospital. I wrote so much about this hospital stay down in a journal. It is way too much to share in a blog post. Maybe one day, if I ever get around to writing a book, I’ll hopefully be able to include much of it in my book!

Thank you for reading! Until next time…
Sara Breidenstein
Kissing Stigma Goodbye

Thursday, January 2, 2014

My Recent Hospitalization (Part 2)

After a long couple of months of a deteriorating mental health status, of pure misery, of truly touch and go symptoms, feeling completely out of control, and wanting to end my life so badly; I made the decision to go to the hospital. I stopped denying the situation and blaming it on life situations and took the first step in taking control of the situation. The decision to go to the hospital followed weeks, maybe more, of absolute pain and suffering that no longer felt bearable. I made the decision that I would go to the hospital on Thursday night, December 19, 2013. I had decided that I would go after the work holiday party scheduled for the following day. I just had to get through a few hours of work and a few hours of the holiday party Friday.

With tears in my eyes, I told my mom of my plans and told her I would be going by myself and I would update her of the outcome. This night, Thursday night was the first I was able to cry in a very long time and it felt good. After telling my mom of my plans, I did my laundry, I packed a bag, and I prepared myself as best as possible for what would be. Mom took care of telling the rest of the family for me. As I left for work the next day, I took my carefully (hospital approved) packed bag with me. I threw it in my trunk to be forgotten about for the day but that turned out to be impossible. Everything made me think of the fact that I would be taking myself to the ER after work with hopes of being admitted, losing all independence for at least a few days. I was concerned. I was concerned about almost everything.

What if they don’t hospitalize me? What if they just send me home? I’ll probably end up harming myself! How much should I tell them in the ER? I don’t want to be involuntarily placed in the hospital if they think I’m too much of a danger to myself! What if the hospital is not a kind and warm place to be? What if I feel like they’re not helping me? What if they don’t discharge me when I request it and I’m stuck there? What if I’m not out in time to return to work on January 2nd? What if I can’t have access to water all the time? I’m always thirsty! What if they don’t give me Ibuprofen for my neck when I need it? What about tums? I’ve got terrible acid reflux! Will they give me tums? How am I going to write? I need a notebook without metal spirals (Dad saved the day on this one)! Will they let me have pens? What can I have? What about my psoriasis? Will they allow me to have my cream for that? Can they even help me? Maybe I’m too far gone! What can they do in a few days for me? What if? What if? What if?

It was a night and day full of what ifs?!?! My brain just couldn’t stop thinking of what could go wrong and start thinking of what could go right! I pushed myself through work and through the holiday party. It wasn’t really that hard to do because it was keeping my mind occupied. Partly through the day, I sent a text to my mom “I don’t want to go to the hospital alone.” She agreed to meet me at the hospital when she got off of work. I got out of the holiday party around 3pm and headed over to Saint Joseph’s Medical Center (SJMC). I sat in my car in the parking lot of the E.R. with about 45 minutes to kill until my mom would arrive. That is when I wrote my thoughts and feelings down to assist me with communicating effectively with the hospital staff. Some of those thoughts and feelings I posted last night. When I completed that I just enjoyed (or tried to enjoy) some music while waiting for my mom. I did not want to go inside without her. Eventually, just before 4 p.m.,I went inside because I had to go to the bathroom so badly. Mom arrived shortly after I checked in and remained with me until I was transferred out of the ER.

They called me back to triage me after only a 10 minute wait in the waiting room. When I told them I was having suicidal thoughts, they quickly changed their minds about the normal triage process and took me back to a room immediately. Once in the room, there were 3 nurses surrounding me while I had to take my clothing off and put on a hospital gown. One was taking my blood pressure, another asking me questions, another preparing to take my blood. It was all incredibly overwhelming. No surprise my blood pressure was sky high. Higher than it’s ever been. Wouldn’t anyone’s be high with three nurses surrounding them like that? When they all finally left my room, I sent one to get my mom out of the waiting room. While they were getting her, the one nurse, who was set to be my nurse for the remainder of the shift came in to talk to me about what brought me into the hospital. She was incredibly kind and caring and didn’t once make me feel any shame for being there. Instead, she made me feel comfortable being there and as if I had made the correct decision in going. She told me she was sorry I was feeling that way and she hoped I feel better. In fact, just about everyone else I came into contact with in the ER made me feel that way. The nurses and doctors in the ER were incredible! It was the complete opposite of some of my past experiences at.

First, I met with a medical doctor to receive medical clearance. That happened pretty quickly. I’d say within an hour or so of arriving at the ER. I met with the Social Worker pretty quickly as well. I then had to wait for the Psychiatrist. Psychiatrists in the evening hours at the ER are more of an on-call type position and I had arrived shortly after shift change (darn). Once the Psychiatrist arrived she met with me pretty quickly and agreed that being an admitted was the best thing for me at the time. I signed the voluntary papers and she and the Social Worker began working on getting insurance authorization and checking if a bed at Saint Joseph’s was available. I lucked out, a bed upstairs (one floor up- directly above the ER) in the Psychiatric Unit at SJMC was available and my insurance authorized me to stay. I was however, worried that I wouldn’t receive enough treatment. The Social Worker in the ER told me I was only authorized through Monday December 23rd. My mom and I were worried that I would basically just be in the hospital over the weekend and weren’t sure how effective that would be for me. Would I even see a doctor? A Social Worker? Would they help me find a new doctor? A therapist? I was worried! I was stressing a lot about the Monday timeline! Once I got on the unit and spoke to my doctor it became more apparent that they would obtain an extended authorization as needed and they did just that. My authorization was extended until Thursday December 26th

After talking to the Psychiatrist, finding out there was a bed on One West (the Psychiatric unit), and finding out my insurance authorized the stay it was just a matter of the nurse calling to One West and letting them know I was ready to be transferred up there. Unfortunately, just as this happened, my nurse was called to an emergency which took quite some time. I was stuck in the ER waiting for a bit longer. It took about an hour and a half to two hours from the insurance authorization to my transfer upstairs. I still thought the timing was quite good. I arrived at the ER around 4 pm and was transferred to the Psych unit just after 11 pm. The last time I was hospitalized, I sat at GBMC for about 16 hours with a bed awaiting me at Sheppard Pratt while all I was waiting on was medical clearance. 7 hours seemed great to me! Everyone in the ER was truly incredible and caring. It was a very positive ER experience.

Once I got on the unit, they went through my stuff and took a few items I couldn’t have; I did a pretty good job of packing to psych hospital standards. They then did my intake, gave me my medication, showed me my room and I was out like a light! I was woken up bright and early for a blood draw and then my vitals. I saw a Psychiatrist first thing Saturday morning, which eased my stress a lot!

More to come on my actual stay on the unit!

Thanks for reading! Until next time…
Sara Breidenstein

Kissing Stigma Goodbye



Wednesday, January 1, 2014

My Recent Hospitalization (Part 1)

This will be my first in a series of posts about my recent hospital visit. I will start with what led me to the visit. The ultimate decider in going to the E.R. was my suicidal ideations. I was very focused on the idea of no longer wanting to live. Every night I hoped I wouldn’t wake up. I would stare at my bottle of lithium thinking about just taking the entire bottle so I would not have to wake come tomorrow. I attempted suicide 6 ½ years ago at a time in which I was feeling much like I was feeling prior to going to the hospital. I was in a mixed state. A mixed state is when someone has feelings of both depression and mania at the same time. It is a very dangerous place to be when you’re having suicidal thoughts. When someone is depressed the suicidal thoughts may be present but the energy and motivation is often times lacking. When someone is in a mixed state the suicidal thoughts are present and so is the energy to act on those thoughts. This therefore makes mixed states the most dangerous state for an individual with Bipolar.

The suicidal desires are what brought me to the hospital but they were only one part of the problem. There were many other symptoms present that I had been fighting and denying for a long time. I was in a full-blown mixed state and was feeling entirely out of control. My symptoms started months ago. I honestly can’t think back to exactly when. However, they worsened with my recent discontinuation of Lamictal. I wasn’t aware of their worsening. In fact, I thought I was doing just fine. I blamed everything I was going through on subpar life situations. I had even become very resentful towards friends and family for they had what I could never seem to obtain but wanted so badly. Finally, I lost it one too many times and realized that I couldn’t go on like this anymore. There are many occasions in which I am amazed that I didn’t do something to take my life. I always thought about not wanting to hurt my family in these cases and it was the only thing keeping me alive. I felt so out of control and I knew I needed help. The night before I went to the hospital, I decided I would go to the ER after work the following day. I told my family of my plan, I packed a bag, and I prepared myself for the hospital. It was such a hard decision to make, to give up all control and trust to a locked facility. It ended up being a very good decision (which I will talk about more in days to come). The piece I wrote two nights before going to the hospital really allowed me to begin to externalize how I was feeling. I had been internalizing for so long and writing this piece gave me the insight I needed to realize how bad off I really was. The link to that piece is here: Tomorrow Is a New Day

To give you a small taste of where my mind was at, I am going to share some of the things I wrote down in a notebook prior to going to the hospital, both the night before and the day of. The things I wrote the day of, I wrote down to help me better express to the doctors and nurses at the hospital how I was feeling because I don’t do well at verbally expressing myself.

I jotted this down the night before I went to the hospital. 

I can’t go to the hospital. What about my dog? He’ll really miss me while I’m gone. If I don’t go to the hospital I may kill myself. I probably will. What about Caesar? He’ll be really sad! Mom and Dad will take care of him but he’ll never be the same. Too bad I didn’t succeed 6 years ago. What if I don’t succeed again? What if I end up a vegetable? Will they pull the cord? I hope so. Poor Caesar. This isn’t fair to him. My parents will be better off without me. No matter what they say; I just complicate their lives. They should have made me happy. They made my sister happy. Why didn’t they make me happy?

I jotted the following down shortly before walking into the ER while I was sitting in my car outside of the hospital preparing my thoughts. This was immediately after my company holiday party, which I attended and put on a happy face at. I did not share that I was going to the ER for suicidal thoughts right after with anyone but one person. I pushed myself through work until my 12 days off. After all, work was the only thing at the time that actually made me feel good!

I can’t find the worth in my life. I know it doesn’t exist. Everyone tells me there’s worth in every life but I don’t believe them. There’s not worth in mine. Every single day I want to die. I hope that I won’t wake up in the morning. I feel hopeless. I feel desperate to end the misery. I can’t see a positive future. I can’t see any other way than death for the misery to end but I don’t want to hurt my family. I just want to be happy but it seems impossible. It’s not fair. Why should I have to live in such misery? I resent my family, friends, and coworkers who seem to have everything I’m missing. I don’t know when I’ll just lose it and harm myself with plans to end it all. It’s nearing closer and closer and I don’t trust myself after my impulsive overdose 6 years ago when I felt similar. The littlest things in conversations will set my brain off. I need help fast!

I also jotted down a list of some sort related to my thoughts and feelings:

·      Sad
·      Discouraged
·      Hopeless
·      Alone
·      The desire to no longer live
·      Irritated
·      Agitated
·      Anxious
·      Trouble sleeping
·      Racing thoughts at times
·      Pressured speech at times
·      Restless
·      Hate and resent towards family and friends
·      Attention problems
·      Impulsive (i.e. spending)
·      Sometimes I feel hypomanic symptoms and sometimes depressed symptoms and sometimes both all at once

This is a small peak into where my mind was at prior to my hospitalization. I thought sharing some of what I jotted down could be useful as it is raw, straight from my brain to the paper, a real look at what was going on in my brain and why I went to the hospital. I will follow this up in a day or so with my experiences in the hospital, staring in the E.R. and all the way until discharge

Thank you for reading! Until next time…
Sara Breidenstein
Kissing Stigma Goodbye