having no doctor

I made some calls yesterday, trying to chase up that CBT referral. The receptionist informed me that due to massive backlog, there are no new patient appointments until March, and hence they wouldn’t be sending out any letters until the new year, because, and I quote you direct “if we send them out now you’ll lose the letter and then clog up the phone line trying to find out when it is.” Good to know you have such a high opinion of me from the start.

Regular readers will remember that I used to see a brilliant psych consultant called DrF on the site of the hospital where I work, but they had a shuffle round and he would only be seeing in-patients. Hence when I ended up under the care of the crisis team in September they suggested that since I was going to have to repeat my life history to a new doctor anyway, why not have myself referred via my GP to a consultant at the hospital which is round the corner from my new house.

I went to the GP who said she would write a referral letter. The crisis team said because I was known to the trust (the mental health trust is all one and the same, with wards and services on the site of a number of different acute hospital trusts) that I wouldn’t have too much of a wait before I got an outpatient appointment. A month or so later I went back to the GP as I hadn’t heard a thing, so she said she would check with her minions that it had been sent. She never got back to me, it was obvious at the time that she didn't have the time for mental people; but whether or not she chased it up, I've still heard nothing from the hospital. Maybe she never wrote one??

So as it stands at the moment, I’ve no psychiatrist, and no CBT, and when I moved house which was in February I self removed myself off the CPN waiting list as well. So given that technically that means I am under no ones care, I technically aren’t mental.

I was initially pleased, like, yey me!! As if they had thought I was any kind of risk I wouldn’t have been aloud to float off under the radar. But, it has occurred to me that if anything now happens, I am at increased risk of being admitted because there is no support network. During my past two encounters with the Crisis Team; because of my good backup i.e. DrF and the nurse practitioner at my old GP’s, I have been allowed to stay at home. But now, I don’t have that back up.

The obvious answer is to stay not mentally interesting. I hope I can do that.

CN

Millon Cinical Inventory

I said I would write about my 3rd and final meeting with the psychologist; so here goes:

Background for those not up to date with this story - -after I had a bit of an episode [end August/early September] I found myself under the care of the crisis team. This involved 3 sessions with a psychotherapist who worked in the team. For a very brief overview of these meetings see this post

http://blogofcrazynurse.blogspot.com/2009_09_01_archive.html

At the end of the first session he gave me a questionnaire to fill in. I am old friends with Beck's Depression Inventory and the HAD score; and know exactly which boxes to tick in order not to trigger. But he gave me something I had never even heard of before, let alone seen or used. It was the Millon Clinical Inventory III. It was composed of 175 statements with option tick box 'true' or 'false'.

Despite being asked not to, I asked Dr Google about said questionnaire.

It purports itself to be 'an assessment of DSM-IV related personality disorders and clinical syndromes'. But sadly, it turned out that I would have to pay to learn what to tick to stay away from any diagnonsenses or labels. So much for freedom of information and the superhighway. Anyway, back to the point. Payment really wasn't an option (credit-crunch, public-sector-pay, woe-is-me, etc, etc)

So I decided to fill it in honestly. This actually turned out to be more difficult than you might suspect, mainly because after I'd answered all the trues and then all the falses, I was still left with a number of questions where I fell into both categories on different occasions. I deliberated for too long over these, in the end opting for I how I felt right now to answer them.

So I gave it back to him at the end of the second session. Thus, when I returned for the third session, he had analysed the results, and he went through them in great detail with me. I think it is a good thing that I am able to say that none of his conclusions about my inner personal where too far of the mark. They were acutely awkwardly too close in some aspects.

He presented me with a line graph and a detailed breakdown of my scores. I am not delusional or psychotic. I am clinically depressed. I was borderline for anxiety and borderline personality disorder. I could deal with borderline. Its not enough for a diagnosis.

Of course, this was merely a paper exercise. I know from experience that, well in medicine at least, the best observation tool any health care professional has is his or her eyes. That will tell you plenty, without any monitor or paper exercise. But assessment tools have their place.

He said he was going to refer me for CBT. So far (and it was 10 weeks ago now) I've not heard a peep from anyone. Which reminds me, my GP has written a letter asking for my psychiatry out patients to be moved to the hospital nearer me. This was sent 10 weeks ago and I've heard, you guessed it, nothing. Most weeks I tell myself I am going to get on the phone and chase this up. But inevitably I don't. Which is fine for now, because I am okay, and even when my mind is wandering, I have rational thought and the ability to rubbish away other thoughts. My concern is that if a few months down the line, I find myself in a position where I am unable to do so; then getting help will be impossible as technically right now I don't have a psychiatrist. Sigh

CN

xXx

It's been a long long time . . .

Wow. It's been 9 weeks since I last posted. It feels like that long, it feels longer.

The great news is my lack of postage is because I have been out and about, living my life, and enjoying it.

Referring to my last post; I did indeed go back to work on the Monday (Sept 14th) I was only in for two days, as on the Wednesday morning had my third and final appointment with the crisis team psychologist, which I will write about in detail on my next post. Fascinating stuff. Then on Wednesday afternoon I travelled south for my friends wedding. I was the bridesmaid. I'm sure I must of mentioned it before on here. Anyway, yeah, it was a stressful couple of days pre-wedding but the everything was sorted in time for the big day and she had an amazing time, as did I. I got drunk of Champagne which is curious since on the rare occasions prior to this that I've had to have a glass, I've not really liked the taste.

Back into work the following week; only for three days: as Thurs and Fri 24th and 25th Sept were my uni induction days. There is a very small number of us doing the course, all currently employed in the NHS. Nurses, midwife, radiologist, ambulance crew, OT's - a real mixed bag. To me that makes it even better, as there are a lot of different perspectives on the same scenario. There are only a couple of us doing it part time, the rest doing it full time over a year. In hindsight I wish I had done the same but thats a ramble for another time.

The following two weeks I was in uni solidly. The course has 3 research modules where you go off and do your own thing; and 3 taught modules. The taught modules are generally composed of one or two weeks of lectures and then you go off and do your reading and submit essays; so its still massively self directed.

So I spent two weeks in uni, and then I flew to India on October 10th.

Let me tangent off for a minute about holidays. I am ridiculously crap in hot conditions. The last time I had a beach holiday was in the summer of 2002, just before I started university to do my nurse training. I spent a week in Gran Canaria with two mates. I spent the whole time wilting in the heat, whinging that it was too hot, pissing them off and in the end pissing myself off too. I learnt my lesson. No more sun for me. Since then the few holidays I have taken have been spent either in a European city, or whooshing down the alps on my skis. But my friend, the one who just got married, was marrying a guy from an Indian family and so they were also having an Indian wedding. There was no way on the earth I wasn't going to be there, so as soon as she told me I prepared myself for a hot holiday in the Indian Summer.

I went for two weeks. The first week we (me and her man of honour) travelled round the Golden Triangle of North India - Delhi, Jaipur, Agra. Then the second week we flew south for her wedding.

I worked out that the last time I had a two week holiday was 10 years ago, when I went to California with my parents. I was 17 at the time, initially I wasn't going to go as they had planned the trip for their 25th wedding anniversary. But then I got hit by a car and ended up dropping out of my A-Levels, with a plan to start them again the following September. So out of sorrow, they re-invited me, and out of self-pity, I accepted. Sorry, I lose my train of thought. My point is, the second week makes all the difference. Really made it seem like a holiday. I had a fantastic time, truly forgot about work or uni or mentalness; just enjoyed myself. Truly amazing time. Didn't facebook, read a blog, nothing - for two weeks. It was liberating.

So by the time I did return back to work on Monday 26th Oct I had actually had four weeks off! And the previous two weeks before that I had worked a sum total of 5 days. And, got paid for it all!!! It wasn't as bad as I had imagined it to be. The place was much the same, the people were much the same. No one new, on one had left, no dramatic changes; not that I was expecting any.

I am now working 3 days a week, with 2 days study leave and two days off a week. I have been rigid about only working extra bank shifts on the days off or extensions of shifts I am already working; so that I am still having two days a week to do my work for uni. There is a lot of it, but at least its stuff I am interested in. I bough a fancy corner desk and sorted out my wireless, so the office is up and running.

I am still waiting for an appointment with a psychiatrist in the hospital where I am now being treated. The crisis team psychologist also referred me for CBT and I am still waiting for an appointment for this. Thinking about it, its been like 6 weeks now. I have inspired myself to give them a ring and see what the deal is.

My blood sugars are brilliant, well for me. I haven't deliberately omitted insulin or had a (large) sugar binge in over 2 months. I am sleeping well, I am eating well. I am being disturbingly inactive. I didn't go to the gym for two weeks after I came back from India. Combined with the two weeks I was in India; effectively I may just as well have burnt my membership fee that month. I have got a little bigger. And while it does bother me, and I am fully intending to loose it again before Christmas, I took the decision that getting my presentation and essay finished were higher priorities. It was me who went ahead and did not go for a run for a month. Its only now I can see it, but getting onto this course has really boosted my confidence, I feel like while yes, I would like to be thinner, thats for me, to please myself. I feel accepted by my course mates, my friends and my collegues. They don't mind that I am a little bigger. To them I still have the same worth. So I can deal with my size in my own mind for now, because I believe I have done the right thing.

My crap arsed GP's wouldn't give it me my fluoxitine on repeat prescription without seeing a doctor for a medication review; and then wouldn't give me said review for a week and a half; so I had a hideous five days where I went cold turkey from 60mg to no fluoxitine, and got some nasty gastro side effects. Then I recommenced straight away on 60mg and experienced more nasty side effects. Seriously, they were the most rancid smelling burps I have ever known. Attractive. But I seem to be back to normal now. Sorry body.

I am way behind in blog land. The only person I have caught up with since I came back from India is Lola - and much love to you hun.

The rota for December is out. I am working Christmas eve and day; but got new years off. I can live with that.

xXx