Out Of Control – Me On Steroids

There I was, having been told that there was a good chance that my hearing loss was due to my own actions. Not an easy thing to deal with. Part of me absolutely felt angry with myself, was blaming myself; I have a natural tendency to be very hard on myself – especially when the consequences of my actions turn out to be severely negative. But, there was also another part that just felt confused, because whilst the second most recent overdose was certainly a serious one, the most recent one was one where I didn’t ingest more than about half a teaspoon of the chemical, and I couldn’t quite understand how it could have had such a drastic effect on my hearing. But, clearly it had.

The ENT specialist had prescribed a high dose of Prednisolone which I was to take for a week in the hope that it may reverse some of the recent hearing loss. The name of the medication did ring a bell at the time, but not loudly enough for me to clock why, so I went down to the hospital pharmacy and picked the medicine up. It wasn’t until I got home that I remembered that this was a medication which a previous GP had refused to prescribe when my asthma was really bad, because she felt it was too much of a risk, putting me on it. There were two reasons for this: firstly, that people with a history of serious mental health issues are particularly prone to react badly to this medicine, and, secondly, that I have in the past had extreme adverse reactions to three other medications [one of which I was reacting to when I took the second most recent overdose], so the doctors are always very cautious about prescribing any non-essential new meds to me.

But, there I was with the medication in my hand, not knowing whether or not it would really be a good idea to take it. Yes, this medication could potentially save me from needing cochlear implants down the line, but, at the same time, if I did have a really bad reaction I could end up putting myself at considerable risk. The ENT specialist wasn’t someone who knew me well [or at all, really], so when he prescribed it, he did it on the same premises he would for anyone else; ‘Worth trying, no harm done if it doesn’t work’, whereas I knew that this medication could spell real trouble for me.

There was a part of me that was genuinely scared of a bad reaction; I knew perfectly well the horrible feeling of being out of control because of a medication. I had been through it three times.. Yet, there was another part that so badly wanted to be able to do something to reverse the damage I had apparently caused.

I spent a week going back and forth, unable to decide what to do, talking it through with lots of people, knowing full well that, ultimately, it was still my decision to make. I did speak to my GP [well, technically, the receptionist spoke to her on my behalf], and she said that it would be ‘perfectly fine’ for me to take the steroids, and – after all – I had had no adverse reactions to the steroid injections I was given when treated for anaphylaxis.

In the end I decided that I would give it a go, because I knew that if I didn’t I would always be wondering ‘What if..? What if..?’.

Still, to be on the safe side, I decided to start the course early Monday morning, so that if I did have a bad reaction I would be seeing P. later that day. [With two of the three medications I had previously reacted badly to, it had happened literally within a few hours of taking the first dose]. I also had a doctor’s appointment on Tuesday, and scheduled a ‘just-in-case’ appointment with K., my synagogue social worker who I have been seeing semi-regularly, for Wednesday afternoon.

Monday came round and I took the first dose, which – as this was a high dose treatment – was a good handful of pills, making me feel as if I was actually overdosing on tablets. By the time I was due to see P. – about six hours later – I already knew something wasn’t right. I could feel things firing in my brain, rapid electric sparks in my head, and it was as if I couldn’t keep track of my own thoughts. It was a truly bizarre experience. – Anyone who has ever been seen by the mental health crisis team knows that one of the questions you will be asked during the assessment is ‘Are you having racing thoughts?’. Being prone to deep depression and suicidal ideation rather than mania I have always answered ‘No’ to that question, not really knowing what ‘racing thoughts’ actually were. I’m telling you, by noon that Monday I knew exactly what they were – and it was freaking me out, big time!

So, I had a crazy rambling session with P. that day, very unlike any other session I have ever had. I also spoke to H., my care coordinator, that same afternoon and she sorted out a referral to the crisis resolution team for Wednesday, as it was clear I was not in a good way and would likely need the extra support, particularly over the weekend.

On Tuesday morning I went to see the doctor – an absolutely lovely F2 who I hadn’t met before. By then I had taken the second dose of Prednisolone – more out of a sort of manic compulsion than anything else – and consequently the reaction was getting worse. I had also used a surgical scalpel and cut myself very badly in two places; enough to warrant stitches. The doctor’s reaction was ‘Come off these meds immediately – this is a really serious and abnormal reaction!’.

I explained to her the reason why I was on the treatment in the first place and why I was finding it hard to ‘just stop taking the meds’, and this young doctor was absolutely brilliant. She sat back and listened to me carefully and then took the time to make five or six phone calls – while I was still in the room – to get hold of an ENT registrar to find out what the implications of stopping the treatment would be for my hearing, so that we’d be able to make an informed decision. The ENT registrar told her that as treatment had been delayed by several months already [Urgent NHS referral, remember?] it was unlikely that my hearing would improve, that the specialist who prescribed the steroids probably felt it was worth a shot – even if it was a shot in the dark – because sometimes people do respond, even with delayed treatment. But, the registrar concluded, in light of the extreme reaction I was having it certainly wasn’t worth staying on the meds, as the odds of success were so small.

I felt really reassured in that moment that I wouldn’t be missing out if I ended treatment prematurely, because the odds of any improvement were so small. It made complete sense to stop taking the meds.

But, then I got home, and I was still hyper and there was so much in me saying that firstly I was already dealing with the adverse effects of this medication [the GP had explained that it would more than likely be a few days, maybe even a week, before the chemicals in my body would stop messing with my brain].. and it was only a few more days to go.. and what’s to say that I couldn’t have an equally abnormal positive reaction to these meds..? After all, my body is clearly highly sensitive to small chemical changes..

So, the next morning I took the third dose, against medical advice. This time it wasn’t manic compulsion that made me do it, but that part of me that just needed to hold on to hope, that simply couldn’t give up, even though everyone around me felt this was a very bad decision, indeed.

I spent time in my session with P. that day, exploring why it was so terribly hard for me to stop taking the tablets, even though the rational part of me knew that the chance of a positive outcome was incredibly slim – and that was really helpful, even with the chaos raging in my head.

I also had a good chat with K. that afternoon. She was characteristically open, direct and honest with me both about her anger and her disappointment that I had carried on taking the medication in spite of what the doctor had told me, and in spite of the fact that I had felt completely reassured at that point that I wasn’t missing out. I told her that I would think very carefully about handing the meds in to P. the next day, but I was also clear that I wasn’t prepared to make any definite promises, because I simply didn’t feel that I could. So much of me felt out of control and I just couldn’t say that I’d be able to do that, come morning.

Oddly, the thing that made me realise just how out of control I really was wasn’t the fact that I had cut myself so badly, but the fact that I found myself at a McDonald’s having a Big Mac.. I’ve been a vegetarian for something like twenty years, and I keep sort-of-kosher, so for me to sit down and eat something like that goes against so much of what I believe in. It is something I simply wouldn’t ever do, if I were in control of my actions..

I did end up giving P. the tablets the following day, but not before having taken a fourth dose that morning, this time – again – in a very compulsive manner. There was no reasoning whatsoever, just acting: I simply couldn’t not take them. This made me realise that I really needed to view the tablets in the same way I did my scalpels and cords [all of which I had handed in to P. two days earlier, feeling too out of control to be safe with them]; while I was still having this strange reaction I just couldn’t manage the tablets responsibly.

It took a good while after that final dose before I felt completely back to my normal in-control self, and I carried on working with the crisis resolution team through the weekend and most of the following week, just to be safe.

I am really glad that I had as much support available to me as I did during this time, because it was incredibly frightening to be so out of control. The experience was very different to other times when I have felt out of control. Whilst what came out in the midst of this whole ordeal – feelings, thoughts etc – were things that were almost certainly already brewing inside, it was – at least the way I look at it – triggered by outside factors. And that’s quite a scary thing.

All the very best,

xx

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I’m Alive, I’m A Mess

It’s been a physically and emotionally exhausting few days and I really ought to be asleep right now. It’s 4.30am at the time of writing, yet, inspite of being tired in the extreme sleep evades me.

Things have been shaky in the last few weeks, to say the least. A lot of flashbacks, and on top of that I’m on a hormone triggering treatment which makes me even less stable than normal. We are talking an emotional rollercoaster of going from blue skies to pitch dark in seconds flat, up and down, round and round. Not an enjoyable ride in any way, shape or form.

And at some point in the midst of all that my poor impulse control won over the utilisation of coping strategies; I decided that having a bit of ethylene glycol would be a good idea. I think it was only a tiny amount to start with, certainly less than a mouthful. I knew that was a really bad idea, and the following night when I felt the urge I rang the mental health crisis resolution team under whose care I’ve been the last three weeks (with a break in the middle, where I went to stay with my sisters). It was about 1am when I rang and talking seemed to help; by the end of the call I had agreed with K., (the person who was working the night shift), that I would come in to see them at ten that morning and bring the bottle of ethylene glycol for safe disposal. That felt both scary and good. It’s kind of hard to explain, but there is something about having the means to kill myself readily available that feels like a safety net of sorts, something that gives me a feeling of being in control. Twisted logic, for sure, but there you have it. But, it also felt good, the idea that someone would relieve me of this deadly stuff,would, in a sense, save me from myself.

Two hours later I once again felt myself plummeting into darkness and I picked up the phone again, since I had found it helpful the last time, and talked again to K. for some time. I may have come across somewhat incoherent because she asked me if I had ‘tasted’ any more of ‘that toxic chemical’. I said I hadn’t but in the same instance shot a glance at the plastic bottle and it was immediately clear that there was a whole lot more than ‘less than a mouthful’ missing. Alarmingly, I genuinely have no recollection of downing a large amount of this sickly-sweet substance. In fact, and I said as much to K., I wasn’t even sure if I had actually drunk it or maybe just spilled it. Or when this had happened. Still, as there was certainly more than a lethal amount missing from the bottle I agreed to let K. call for an ambulance – but, not before saying ‘Can you wait half an hour to call so I can have a shower first?’, to which she calmly explained that having a shower at three in the morning when you have potentially consumed enough poison to kill yourself was hardly a priority. So instead I started stuffing things into bags: iPad, iPod, mobile, chargers, clean underwear, toothbrush, EpiPen, my journal, a random bunch of puzzle cubes and even my prayer book. I have no idea where this sudden organisational skill came from, I normally have to write lists to make sure I don’t forget things when I pack a bag, but there I was, five minutes later, fully equipped to spend a long time in hospital, should it come to that. Then I told K., who was still on the line with me, that I was going to go outside to wait for the ambulance, promptly grabbed my bags and made it down two flights of stairs and out onto the pavement outside my house.. where I laid down to sleep while I was waiting for the ambulance to arrive. K. kept talking to me, trying to convince me that while it was OK to lay down, if I was too dizzy to stand up, I really needed to stay awake.

The paramedics arrived and got me into the ambulance with some difficulty as my legs refused to carry me properly. They asked a tonne of questions, all of which I answered in something of a drunken stupor. K. had already told them what I had taken, which was probably a good thing as they would more than likely otherwise have assumed I was just another overly refreshed Saturday night party-goer, and might not have realised that time was pretty darn critical. Also, I had brought the bottle with me so they could see exactly what I had drunk and how much was missing. I mainly just remember babbling like crazy in the ambulance before passing out, and the paramedic pinching at the nerves on my shoulders over and over to get me to stay awake.

In A&E I was first put on a drip of pure ethanol, which is one of two antidotes to ethylene glycol poisoning, followed by a number of rounds of Fomepizol. Hurt crazybad, I can tell you that much for nothing. (Imagine the sting of cleaning a wound with rubbing alcohol, and then imagine that kind of stuff going straight into your bloodstream, and you’ll get a fair idea).

The side effect of this, having bare spirit pumped into me was that I got drunker than I have ever been in my life. I’m not someone who drinks particularly often, so I have a very low tolerance to alcohol, and here they were giving me as much as they could based on my weight. Suddenly absolutely everything was hilarious beyond comprehension. I was giggling and rambling and apologising left right and centre, trying to explain that They were making me drunk. In the midst of that I decided that sending a text to let people know I was in hospital was a good idea, only – I discovered later – the text made very little sense, and I managed to send it to a whole bunch of people I wouldn’t knowingly have sent them to.

At one point a friend of mine, having seen my text, rang me (this was as I was being wheeled into a ward, still apologising profusely for my drunkenness) and all she got was me laughing, unable to explain what had happened. Later, when she came to visit me, she said that it wasn’t exactly what she had expected when she called to hear if I was still alive..

Whilst being drunk was not all that bad, it did mean that I was sick a lot. I have a sneaking suspicion that there was a miscalculation as to how much ethanol they were giving me, because last time I was rushed to hospital for having done something very similar (that time, completely on purpose), I remember screaming in pain as the ethanol went in my arm, but I don’t remember being drunk, nor being repeatedly and violently sick.

I had to stay in hospital for a day and a half, on constant drip, most of the time in both arms. It’s still too early to say if I have done any permanent damage to my kidneys and if so, what the extent is, all I know is that I my vision is extremely blurry and I have been sick a number of times even this morning.

I am out of hospital now, back under the care of the crisis resolution team, but as neither I, nor they, think it’s a good idea for me to be on my own just now, an assessment has been set up for later today at Drayton Park Women’s Mental Health Crisis House. As regular readers will know, I have stayed there in times of acute crisis before, and have found it helpful in turning a negative trend, so I really hope that following the assessment they will offer me a place.

Sorry for making this a somewhat long-winded entry, but I think I just really needed to get it all out.
I think I am still a very long way away from truly absorbing how close I got to dying, and writing is often the best way for me to process things.

Do be kinder to your Selves than I have been to my Self.

Much love,

xx

PS. If you are one of my many wonderful friends who received my drunken text and who tried to get in touch with me later, but couldn’t get through and didn’t hear from me: something went wrong with my mobile and I could only send texts, not receive them, and incoming calls only worked sporadically. So, please don’t think I was ignoring you, I simply didn’t get your messages and consequently didn’t know to respond to them.

For some reason this song is playing in my mind. (Although the title of this post is actually from another Heather Nova song).

Starting Over After A Major Therapy Break

A. Is back from maternity leave now. I’ve seen her twice, and it has at the same time been both a huge relief and incredibly difficult. The first time, walking up to her door, I experienced a very strong wish to cut and run, to chicken out and not knock on the door. I was that nervous. I was so worried about how I would react to seeing A. again [or rather the emotional impact it may have] that I actually felt quite sick.

As you know, over the last several months there have been a lot of thoughts and worries swimming around in my system, regarding A.’s maternity leave and her baby and how I would cope with this new situation, but, to some degree I have been able to shelter myself from it, as I’ve not been seeing her. Two weeks ago that particular way of sheltering myself came to an end, as we resumed therapy.

During that first session, I was very shaky. Not just emotionally, but physically, too. I was fidgety and struggled to settle. I had my Rubik’s cube in my hands, as a means to keep my hands steady. Speaking was difficult, and I sat in silence for a good while, trying to figure out where to start.

I can’t even remember clearly where I did start in the end. I do recall talking about the break. How hard it’s been. Even admitting to overdosing, early on; something which I hadn’t decided whether or not I wanted to talk about in that first session. A. asked some questions about that, and I remember feeling that I wasn’t at all ready to look into it properly just then, that I was still trying to get used to being back in this shared space with her, that I needed more time to test that we were OK before launching any major investigation into anything significant. I mean, I did end up trying to explain to her about that overdose, but without really connecting to what I was talking about. In contrast to the second session, where I spent quite a lot of time trying to talk about the emotional side of what really happened that night, what I was feeling before, during and after, and how I look at it now.

I managed to talk a little about my combined fears and hopes regarding resuming therapy; the hope that I will find the courage to talk openly about my feelings surrounding A.’s leave, the experience of once again being abandoned by someone who isn’t supposed to abandon you, and the anger that it triggers deep inside of me, as well as the worry that I may find that I haven’t got what it takes to face it head on. That I will yet again find a way to not have to express these feelings of anger, in order to avoid the risk of that much-feared rejection, which I have come to expect whenever I express negative emotions towards those close to me. I spoke about the knowledge that there is some potentially substantial gain in it, if I do find a way to talk about all of this, as I recognise that whatever anger I have towards A. is also an echo of what has gone unexpressed previously, in similar situation, in other relationships.

So, yes, A. is back and in theory therapy has resumed. But, although it may seem, from my summary here, that I’m well underway and going places, it still very much feels like I am only just testing the waters with A. and our relationship.

Maybe I’m not exactly back to square one, but, I also feel very aware, that I am nowhere near where I was when we left off, and that it will take time to truly open up again, to truly trust in our relationship.

But it’s a start.

xx

Because Tomorrow Might Be Good For Something

*

“..I’m not crazy, I’m just a little unwell
I know, right now you can’t tell
But stay awhile and maybe then you’ll see
A different side of me..”

*

I guess there are no easy ways to talk or write about this, but as this is supposed to be an honesty-focused blog I’ll just tell it to you straight: last week I accidentally on purpose overdosed on my medication. It really wasn’t a bid to end my life, at least I don’t think it was [although I accept that others may disagree]; I didn’t even take all the tablets I had, but it was still a significant enough dose to potentially do some damage. I know my meds pretty well, and I would like to think that I know what would and wouldn’t kill me, but, the truth is – of course – that there is no way to know for sure just how much a of a medication would be lethal for a specific individual; what’s safe for one person may well be fatal for another. In some weird and rather irrational way, it was more like I was testing if it would be possible to swallow enough tablets in one sitting to get to a lethal dose. I think that was my confused logic, anyway, [which, obviously, isn’t logic at all].

I did frighteningly well in terms of establishing that it would indeed be possible, had I wanted to take more pills than I did. But, the second I had swallowed the first lot I instantly regretted it, and I decided I should go to A&E, since the meds I’m on [Amitriptyline] are known to be very toxic. In fact, the highest therapeutic dose is not that far off a dose that would be classified as toxic, and that is the precise reason why Amitriptyline is only prescribed as a last resort, when all other types of anti-depressants have failed.

Again, entirely irrationally, I decided that rather than calling for an ambulance I would get on a night bus to my local A&E, so I got myself out, started walking to the bus stop and only just missed the bus, so I carried on walking in the general direction of the hospital. After a while I began to get really unsteady on my feet, but was still clear enough to realise that passing out on the streets of London on a Saturday night would not be a great idea, especially with a lot of drunk people out and about. So I went back home, got on my bed and blacked out before I could call for an ambulance.

When I woke up it was all dark, so I thought that it was still night, but when I looked at the time on my mobile I realised that it was in fact the next evening, and I’d been out cold for nearly 24 hours and had missed several calls and texts from worried friends. This really freaked me out, since I normally wake from even the quietest of noises.

That evening I again attempted to get to A&E, but was simply still too wobbly and I had to give up and go home again. On Thursday I had an appointment with my GP, and I told her honestly what I had done, and that since I don’t even really know why I did it, or at least, the logic in the moment really wasn’t logic at all, I really needed some extra support. She heard me and then asked whether I wanted to call the mental health crisis resolution team myself, or if I wanted her to do it. I opted for the latter, because I know I would most likely have gone home and talked myself out of ringing them.

So, at the moment I am seeing the crisis team every other day. I’m not suicidal, at least not on a conscious level, but I also think that having some extra support over the next few days is a good idea, wherever that support comes from.

The crisis team, being tied to the NHS, have, as they always do, questioned both my therapy and my therapist on the grounds that they are not NHS and must therefore automatically be harmful to me.

That really makes me angry, since I am a big believer in psychotherapy in general, and in my therapy in particular. For me, psychotherapy is the most appropriate way of disentangling my thoughts and emotions, and to ultimately get away from the intrusive flashbacks and nightmares which push me to act out in this rather extreme way.

That said, what with my therapist being on maternity leave, I do feel that as much as the crisis team and I have very different ways of understanding psychotherapy and the effect it has, I am still glad to be seen by them, because it means that, should I act out again, or miss a scheduled appointment [whatever the reason] they would send the police and ambulance round to check on me, as I am in effect an out-patient and they have a duty of care. Also, they are available to talk to 24/7, should I find myself struggling with thoughts of self-harm or suicide. I can’t promise I would definitely call them if that happened – in fact – I’m fairly certain that I wouldn’t, but at least the option is there.

Hopefully things will improve soon, so I can start looking forward rather than backward, because, who knows..

;

“..tomorrow might be good for something..”

;

xx

;

Heading, and quotes at the beginning and end of this entry are from Matchbox 20‘s track Unwell. © Rob Thomas