I’ve been very sick this week. I was throwing my guts up and, to be euphemistic, losing matter at the other end almost continuously from Monday morning to sometime yesterday. Well, not quite; what happened on Monday was that I was sick (as in throwing up) from about 9.30am to 2.30pm straight, meaning that I had to cancel my session with Paul and a subsequent arrangement for lunch with a friend. Then, suddenly, I stopped hurling everywhere, and seemed temporarily fine. Even though there was almost no risk of it, I convinced myself that I was up the duff and drove round to Boots to buy a pregnancy test. It was negative, of course, as I knew it would be. But knowing something is or isn’t true and actually being convinced of it is, when you’re me, not at all the same thing.
Shortly after I got back from Boots, the diarrhoea started, and on Tuesday the vomiting came back – though this time not confined to the morning. So I’ve been feeling sorry for myself, but I’ll live.
Had I seen Paul on Monday, today (or yesterday, if you must be pedantic) would have been the fourth consecutive day of appointments. I’ve said it before, but I’ll say it yet again; being mental is a full time job.
On Tuesday I went to see Christine, my CPN. I ate nothing beforehand, other than to stuff Immodium down my throat, as I didn’t want to cancel what was only our second appointment. I actually managed to talk to her reasonably well, all things considered.
As I mentioned, in my last psychiatric appointment NewVCB had said to me that she wanted Christine to focus on ‘practical’ stuff in her interactions with me. As you might imagine, this caused me a certain amount of anxiety given my general disdain for the supposedly therapeutic properties of basket weaving, ‘changing’ your thinking, flicking a fucking rubber band on your wrist or ringing the Samaritans (with no disrespect meant to said organisation).
It turns out that Christine’s approach is considerably less shit than the above. I had told her about this blog the last time I saw her, and mentioned that it had been moderately successful over its almost-two years of existence (I mean, compared to the big blogs, this site is nothing. But compared to what I expected, it’s considerably more than nothing). On Tuesday, she brought this issue up – basically she said that if I had an audience, that if people bothered to read the shit I splurge here, that if people interact with me because of it – then I must have some sort of ability to write (personally I don’t think this is the case, although some of you have been kind enough to make contrary assertions in the past. Thank you).
I shrugged at her, and asked her what her point was.
Not a bad one, actually, as it goes. She was wondering if I had considered submitting some of what I write to some of the local mental health charities – Charity A, Charity C, Aware Defeat Depression, Charity B etc etc. She said that these organisations often produce newsletters, and in her opinion they would be “crying out for” a patient with an ability to articulate him/herself to produce a few pieces for such publications. I have to say that I would never in a million years have considered something like this. It simply would not have occurred to me.
I have noticed in the waiting room at Nexus that the organisation compiles and advertises writings from some of their (former?) clients (or clients of related organisations). One lady to whom they frequently allude wrote a book, published by the small, socially-run house of Chipmunka (who are mental health specialists). The verse of others features in the originally-titled Nexus Poetry Book. I remember finding these publications interesting, but I wasn’t somehow inspired into submitting anything of my own.
So, I told Christine that I hadn’t thought of it, but that it seemed like a plausible idea. She said, “have you considered writing professionally?”
Who hasn’t? Seriously, doesn’t everyone grow up wanting to be best-selling novelist? It was something that certainly crossed my mind many times. (Aside from the fact that I haven’t written any fiction since…God, probably since my GCSEs). In real terms, though, I did apply for a few freelance contracts some months ago, and based on samples from both this blog and Not as Smart as Pandora Braithwaite, was successful in securing all of them. The problem was that they, reasonably enough, wanted exclusivity on all submissions.
So what? Well, my writing for me comes first. This blog comes first. Writing here, especially in the highly verbose manner in which I do, can be energy-zapping at times, meaning I don’t have any va va voom left to write elsewhere. If one of the magazines who offered me freelance contracts had been willing to budge on the exclusivity matter, I could have simply sent modified versions of posts from here – but I understand why they won’t do that. By the same token, I have my terms. I am not going to prioritise money-making articles over the therapeutic concern that is this blog.
I told this to Christine, but she reckoned that the local charities wouldn’t really give a shit. She repeated the term “crying out for”, suggesting to me that in their apparent desperation, exclusivity on articles would be the least of their worries. In which case – fine by me. Though as I said on Twitter, if indeed this comes to pass, I will have to edit out the multifarious instances of the words ‘fuck’, ‘cunt’, ‘dickshaft’, ‘tossface’ etc. Null has offered to help me. He is going to be my editor, bitches, yeah! Null advises that I must henceforth use the words ‘fudge’ and ‘cumberbund’ in place of my more typical parlance. For fudge’s sake.
What else? We talked about my ability to get out of the house, and I said that although it was still reasonably poor, it was improving. I told her that I had developed a small but fairly active interest in geocaching (though this was a difficult conversation, because anyone who engages in this practice sounds…well, mad to non-cachers. “It’s a high-tech treasure hunt!” I enthused. She raised her eyebrow, scribbled something down and gently moved the subject on) that was taking me out a little. I discussed how A and I would often go out at weekends.
“But can you go out alone?” she queried.
I laughed in her face. “Of course not!” I said, incredulous.
I thought about it for a minute. I had arrived at the CMHT alone, after all. Why not elsewhere? But the very idea of going almost anywhere else by myself made me anxious, and I started blathering idiotically at her.
She saw my distress, and duly steered the conversation away slightly. “OK,” she said, “but how are you when you’re out?”
“Alright if someone’s there, usually – unless there’s a crowd, or someone sitting close to me or something.”
“And then what happens?”
“I go mental and simply have to get out of the situation.” I thought back to a recent trip to fucking Tesco and shuddered.
“Have you ever been prescribed Diazepam?” she queried. I told her that I had a stash of it at home.
“Not to throw down my throat in a moment of existentialism, you understand,” I assured her. “Just…for emergencies. For when the GPs stop being willing to give it to me.”
“Like a comfort blanket,” Christine said.
The long and the short of this discussion was that she believes that taking a Diazepam, using Diazepam when needed, is better than not going into what I perceive as difficult situations. She told me to take some with me in my pill box and to just take one (or two, whatever), as needed.
She opined that most GPs, if satisfied that you’re not addicted to the things, will be willing to give them to most people. I thought back to Dickhead GP‘s abject refusal to give me anything other than that which the consultant prescribed, but kept my mouth shut.
Christine then talked about volunteering for a while. She agrees with me that I’m not ready to go back to work any time soon, but does think that a few hours a week of this would be a good thing. I explained that volunteering was certainly on my long-term agenda; from an entirely selfish angle, it’s a good way back into work, both in terms of the CV experience and as an ‘ease in’ to a more demanding position. However, for once in my sorry life, my greater priority in planning to volunteer is the altruism involved. If they would be willing, I’d love to do some admin or something in Nexus, given the difference their service has made to my life. Failing that, I’d like to work with Aware or one of the other charities listed above, because their work is so vital to people with mental health problems. For some, maybe those who are not considered worthy of seeing CMHT members or something, such charities are their only lifeline.
Ultimately in terms of volunteering, I’d love to join the CAB, as they have been truly excellent when I’ve seen them regarding benefit issues. That’s a serious commitment, however, as (a) you have to be willing to give them at least 16 hours a week and (b) you have to do (at least?) a year’s worth of training (an NVQ in Advice Work, I believe). Of course, they accept applications for admin and so on as well, but these tend to be quite oversubscribed and anyway, I think that ultimately the proper training would be an excellent opportunity both in terms of my career and vis a vis ‘giving something back’.
Anyhow, Christine was essentially suggesting I apply for some sort of volunteering position now. She agreed that the CAB one should be much further down the line, but went on to say that in the case of the other charities, they may only want a few hours a week from me, and in any case, that the application processes were notoriously long (probably because of a dearth of resources). I said that I took her point, but I wanted to be certain that I was ready to move into this domain, and that right now I’m not. She accepted that, but told me to keep thinking about it. I will. In the meantime, I will see if the aforementioned charities are indeed interested in any of my written ramblings as she suggested.
I told her that I was having an ECG the following day to see if NewVCB could increase my dose of Venlafaxine to 375mg daily. Christine said that she thought that would be great; she said that she knows that that dosage is pretty hardcore, but given the chronic and severe nature of my depression, and especially given that 300mg has made such a difference so far, that she agreed with NewVCB that it could be a productive way to proceed.
This led to a brief discussion on NewVCB. Christine loves her. She told me that NewVCB does home visits to the most ill in the community – apparently this is exceptionally rare for consultant psychiatrists (I’m sure it is, though I was reminded that when Paedo first started going really mental, a consultant was at his house within 24 hours. The McFauls seem to get everything they want from the NHS, which is odd in itself; it is made all the odder by the fact that they are under the same Trust as me!). She went on to proffer the view that NewVCB is the best consultant in the area – she meant in terms of her personality and devotion to her patients, I think, but there was also a suggestion that she meant medically too. Based on my admittedly limited experience of psychiatrists, I would agree with this assessment. One thing that continually sticks in my head is the time that NewVCB said to me, “you do know that you can ring me if you need to, don’t you?” I didn’t – not before she said that. I thought that, unless I was crisis-team mental (does that kind of state even exist? I loathe the crisis team beyond words), that I was completely alone out here on the outside.
Finally, we had a discussion about Paul, and about how things are coming to an end with him in the next six weeks or so. I told her that NewVCB had intended to discuss my care with her in relation to the immediate aftermath of that, but Christine didn’t take the bait on that, and instead started wanking on about whether or not I felt “abandoned” or something.
I told her that I didn’t feel abandoned in the least. In part, that’s because Paul himself thinks that the time limit is a crock of shit and is enforcing it only because he has to. In part, it’s because whilst I’m very fond of him, I’m not reliant on him the way I was with C. In part, it’s because I am stronger and less borderline now.
What my problem with the discharge is, I said, is that very productive work had been going on with Paul – but that it is far from finished (by his admission as well as mine). I was abused, badly, for years. Not to mention all the other crap that came with life – Hideous Ex, V, bullying, grandfather’s death, yadda yadda. I’ve read the literature. I’ve spoken to others in similar positions. I’ve even asked the fucking professionals. And the consensus is the same: trauma therapy cannot be adequately conducted in a matter of weeks. It can take years. I told her so, and she accepted that.
And that was that really. I’ll see her again in three weeks, at which point – particularly if I haven’t seen NewVCB in between – I’ll ask her if we can increase the frequency of our meetings whilst Paul is out of the picture. I have no idea if she’ll agree – though I think NewVCB would be happy for her to, so there’s no reason why not that I can detect – but we’ll see.
I like her. I feel able to talk fairly openly to her, which is not normally an easy thing to do. I can’t necessarily see myself getting close to her as such, but I can see her being helpful and supportive, and right now I think that’s all I really need her to be. As you know, I was cynical about the role of CPNs when the idea was first mooted to me about a year ago, but I am happy to have been proven wrong in this instance.
The next day I turned up at the same hospital for the ECG. I was 20 minutes early, but went into the “waiting room” (a few broken plastic chairs strewn over the corridor of the crap mobile building) anyway. Immediately, a young girl stuck her head around the door, into where I stood (I was too scared to sit). The poor cow is obviously marked for NHS redundancy, because she actually didn’t keep me waiting and didn’t fuck about. Despite my o’er-timeliness, she brought me into the crap room straight away, cheerfully gabbled out the usual small-talk (traffic, weather, her fiancé), hooked me up to the machine, waited 10 seconds, glanced at a print-out, then advised me that I was “all done”.
She was obviously not a doctor, because she couldn’t read the results of the test herself. She said that she’d sent it to NewVCB for analysis but – and this is hilarious – it needs to go, firstly, to Big Bastard Hospital That Everybody Hates to be lodged on the computer as “[they] don’t have a computer [there]”. Once lodged, it then goes back to this hospital (the same one in which I see NewVCB and Christine and, formerly, C).
I arrived back at my mother’s house before my allocated appointment time. I couldn’t have been in the room for more than five minutes.
Finally, to today (or rather yesterday, but meh). At 8.30am, I had an appointment with Lovely GP. I cursed myself for booking such an early slot when my alarm went off this morning, as I do each and every time I see him. The reason for doing so is that, as his first patient, I won’t have to wait for my predecessor to take up more than 10 minutes of his time like I normally do.
I had essentially made the appointment to discuss the usefulness or otherwise of Orlistat, which he had prescribed me the last time I saw him to try to help combat the weight issues resultant of taking Seroquel. Knowing, however, that I had stuffed my face with more chocolate in one day than can be found in an entire Cadbury’s factory in a decade, I chose not to bring the subject up.
Instead I told him how much better I was feeling, and we had the same discussion around Venlafaxine that I had had with Christine on Tuesday. He said almost exactly what she had: that yeah, 300/375mg is a fuckload to be taking, but that my issues are severe and chronic and if that’s what it takes to mitigate them, then that’s what it takes to mitigate them.
I don’t remember a lot of what was said, as I was still under the influence of Zopiclone. I do remember that he commented, as many people have, that he could see the positive difference in me – to use his term, I seemed a lot more “responsive” (an interesting way of putting it, I thought). I told him about being allocated a CPN and that how, in light of Bye Bye Paul, this was A Good Thing.
Then, cautiously, I decided to ask The Question.
“She [Christine] said…hmm…well, she said I need to keep getting out but…well, crowds still kill me. She said…um…I should maybe…well, you know…”
He looked at me with bemused enquiry etched across his face.
“…God, I feel like I ask you this every time I see you…she said…’get out, take a Diazepam if that helps you get out. It’s better than not doing so’. So I know I must seem like an addict…but could you maybe prescribe me some? Please?”
He sat back in his chair and laughed. I looked at him in irritation and asked what I had done to arouse such amusement in him.
“‘I know I must seem like an addict’,” he repeated. “I last prescribed you Diazepam months ago. And it was only 14 of them even then. No, Pandora, you are certainly not an addict. You are clearly not abusing these pills in any way.”
True – after all, I haven’t taken any of them. They’re all sitting there in my stash box taking up space. Not that I told him that though, because he wouldn’t prescribe any more if he knew that, or at least so I assume. (And at this juncture you might validly ask why I need more of them despite already having loads. The simple answer is that I have no idea. I just know that when I give myself permission to even take a couple of the things, I feel like I have to make up for their ‘loss’ by gaining three-, four- or five-fold more. As Christine said, they function as a security blanket).
LGP said that he “completely agree[d] with the CPN” that it is better to get out and about and pop a Valium than it is to sit terrified in the house and not pop a Valium. He talked about my need for confidence building, the need for me to develop some sense of routine and ‘normality’, and so on and suchlike – though not in the irritatingly patronising fashion normally employed by GPs. The long and the short of it is that he too is pleased with my progress. Result.
I was trying to grab my scripts and scurry away when he asked me about the Orlistat. I had a moment of guilt-ridden desolation in which I considered making a run for it without saying anything, but I decided to be ‘brave’ (!) and admit that my cravings have been completely out of control.
“Let’s weigh you anyway,” he said – to my utter horror.
In a fluster, I went to frantic pains to remove my boots, belt, mobile phone and other encumbering objects from my person in order to fool the scales into saying that I was lighter than I am. I would have fucking stripped naked and picked off each scab on my body if I had thought I could get away with it. Again, LGP seemed to find amusement in my behaviour. I glared at him, and he apologised – but then added, to my utter astonishment, “you do have great capacity to entertain, you know.”
I asked him what he meant. Apparently, I am “charismatic and articulate” and that will “stand [me] in good stead.”
Initially I thought he was joking, but when he said, “really!” and followed it up with an appropriately reassuring smile, I knew that he was being sincere (or, at least, that he thought he was). I could happily have hugged him – how sweet! There are a lot of cunts in the NHS, but I seem to be becoming increasingly lucky in terms of avoiding them.
Anyhow, my efforts to unladen myself worked. My weight is a pound less than when I last saw LGP. A reduction of a pound is fucking crap, I know, but I was genuinely expecting to have gained a fair bit. The Orlistat mustn’t be completely useless, then. He asked me a lot of questions about its (notorious) gastrointestinal effects, and I admitted that whilst they were frustrating and embarrassing at times, that they weren’t that much in excess of my pre-existing IBS. Furthermore, they’ve reduced in severity over time. (Interestingly ((or not if you’re a vaguely normal human being)), the drug’s manufactures, GlaxoSmithKline, admit to indulging in a bit of the ol’ A Clockwork Orange in terms of said side effects. The worse the side effects, they feel, the more likely you are to stick to a healthy diet in order to avoid them).
LGP said he’d give me another script for the stuff, and see me about it again in six weeks. After 12 weeks on it, if you haven’t lost weight you’re supposed to discontinue it, though I suspect LGP may be flexible on that exact timeframe. Either way, I’m glad he was willing to give me more at this juncture – even if the stuff doesn’t work a fuck, I feel less guilty eating when I know I can take it afterwards.
Finally, I asked him if he could prescribe my Venlafaxine on a two-monthly basis, in the same way as the Seroquel is currently issued. After last week’s disaster, I wanted to make sure that I have a decent stock of the horrible stuff at all times – and besides which, Fat Pharmacist is still proving himself to be an incompetent fuck and thus needs about six years’ notice to allow him to practice pharmacy in his pharmacy. I was somewhat surprised when LGP agreed to this request, in the same way that I have always been surprised by Seroquel being issued in this way. I’m a mental. Is it really sensible to give me two months’ worth of both drugs at any one time? (Which is to say nothing of the Zopiclone and Diazepam stashes). As it happens, if I ever do decide to do myself in, it’ll not be by overdosing, as I know that only certain cocktails work reliably, and that if anything else does kill you, it’ll be slowly and horribly. But the GPs don’t know that I know that.
Still, I don’t care, because this will save me an awful lot of hassle in future.
And that was about it. He asked me to come back in six weeks, said he was glad that things were on the up, and told me to take care. I reciprocated, left, hung around the car park for ages waiting for the pharmacy to open, got my prescriptions, drove back to my mother’s, had a few slices of bacon (plus Orlistat, mais oui) and went back to bed.
And now I am back at A’s and about to go back to bed again. Which is a good thing because this nonsense is waaaaaay too fucking long even by my standards. I don’t think Christine had this length of article in mind when she suggested I sow my blogging seed across Northern Ireland’s mental health outreaches.