Early Experiences With Medical and Dental Care

Posted on by Astrid

Today’s topic for Throwback Thursday is doctors’ or dental visits. I have many early memories of medical care, probably because I, being multiply-disabled, often had to visit the doctor. Until I was about nine, that is, when my parents, my sister and I moved across the country and my parents stopped taking me to doctors altogether except when I had everyday ailments.

An interesting question Lauren asks in her original post, is whether your parents were scared of doctors or dentists. Well, truthfully, yes, mine are. My mother had her own fair share of traumatic experiences involving doctors, among which a situation that would’ve been considered medical malpractice had it been in the U.S. surrounding my premature birth. My father, I don’t know. He probably feels he’s smarter than most doctors and hence considers spending time with them a waste of his own time.

All that being said, up till the age of about nine, I was taken for medical care when I needed it. I don’t think I was really taken for health checks except those part of preemie follow-up. I don’t remember most of these visits, except the ones to the eye doctor. My eye doctor was always, and I mean literally always running at least two hours behind schedule. Waiting in the waiting room for her was the worst. Well, no, the second worst: the absolute worst was waiting for her to come back after she’d put dilation drops into my eyes.

I don’t think I was very afraid of needles as a child. In fact, when I needed to be put under general anesthesia for my various surgeries, as soon as my parents allowed me to make the decision myself between the anesthetic mask and the injection, I always chose the injection. I remember being horribly afraid that I would get the mask when I had to have cataract surgery in 2013, even though I’m not even sure they do this on adults.

One thing I did always remember was that the hospital staff would stick me in my toes rather than my fingers for finger pricks, because the nerves in my fingers should not be damaged because of the fact that I read Braille. I had to have a finger prick last year and told the medical assistant that she was supposed to stick the needle in my toe. She explained that she couldn’t, so I reluctantly agreed to have her stick the needle into the side of a finger I hardly use for reading.

As for dental care, I think I did have proper dental check-ups when I was young. I didn’t have problems with my teeth until I was about eleven and fell and a bit of one of my front teeth broke off. That was the first time I started worrying about my teeth. I did need braces, which was quite an ordeal as the orthodontist never explained properly what I could and couldn’t eat, so there were always parts of my braces getting loose.

I am not very scared of doctors. Dentists though, well, it’s complicated. I am scared of dentists, but also scared of losing my teeth. This has led to some rather odd situations in which I sought out dental care that I might not have needed and didn’t seek out dental care that I did need. Thankfully, now that I live in long-term care, I do get regular dental check-ups and the staff and dentist do try their best to make me feel as comfortable as possible.

Gratitude List (January 22, 2022) #TToT

Posted on by Astrid

Hi everyone. It’s time for another gratitude post. I’m struggling a little, but, as I’ve said many times before, this makes them all the more important. As usual, I’m joining in wiht Ten Things of Thankful (#TToT). Here goes.

1. I am grateful to have seen my husband on Sunday. We went to the Subway drive-through to get a sandwich. I chose a turkey one, to which my husband asked whether I took it because of my diet or because I was in the mood for turkey. “Both,” I replied.

2. I am grateful my mother-in-law visited me on Wednesday. We went for a drive around the nearby countryside and for a short walk in a nearby village.

3. I am grateful for muesli for breakfast. I am also grateful the dietitian allows me muesli with some nuts or raisins in it and it doesn’t have to be plain grain.

4. I am grateful for blueberries. When in the nearby village with my mother-in-law, we decided to get some groceries for her. I decided to get blueberries too.

5. I am grateful my dental chek-up last Wednesday was uneventful and, other than the fact that I have inflamed gums, everything was fine.

6. I am grateful for a good laugh with one of my staff on Thursday. I originally was anxious about her being my one-on-one that day, because a few weeks prior she’d triggered me with what she thought was encouragement of my independence. I thankfully talked it over with her and we then laughed our butts off at some silly jokes we were cracking.

7. I am grateful I am inspired to write on my blog. I still struggle to find the motivation to go on walks or to craft, but at least I’m writing almost everyday, sometimes twice a day.

8. I am grateful my nurse practitioner keeps trying to help me and takes me seriously despite how complicated I might be. I have been experiencing increased flashbacks to the time I spent in the psych hospital lately, but I try to remind myself my staff and my treatment team at mental health are different.

9. I am grateful it looks like the essential oils I ordered on Thursday, are on their way. I ordered with a company that doesn’t use the bank’s payment processing system, so I had to make my payment manually, then panicked worrying that I’d made a typeo somehow. Apparently not. Let’s hope the company isn’t altogether lying and will actually have shipped my essential oils.

10. I am grateful I’ve found the courage to experiment with essential oil blends that are slightly different from the ones I find online. For example, earlier I used tangerine rather than orange in a blend that otherwise contained cardamom and cinnamon. It smelled delicious!

What are you grateful for?

#WeekendCoffeeShare (January 21, 2022)

Posted on by Astrid

Hi everyone on this late Friday evening. I’m joining #WeekendCoffeeShare, even though it’s a bit late for coffee here. I am going to grab a glass of water and some fruit in a bit, so if you’d like a soft drink or a glass of water too, you can have one. Let’s catch up.

If we were having coffee, first I’d moan about the cold weather some more. Boy, do I hate winter! Several staff have been trying to coax me into going on walks because it was supposed to be sunny and nice outside. Then I’d invariably reply: “It’s 3°C outside too, brrr.” Usually, the air would become cloudier soon enough and we’d get rain.

If we were having coffee, I’d share that, probably due to my lack of exercise, I didn’t lose weight over the past week even though I stuck to my healthy food plan pretty well. That is, I didn’t feel as though I was just eating carrots and lettuce all week, so maybe I accidentally sneaked in some extras I shouldn’t have had. For example, I am allowed 225ml of yogurt or 200ml of quark with some muesli for breakfast. On Wednesday, my staff poured half the 500ml can of quark into my bowl. Now quark contains only about 50 calories per 100ml, so that didn’t really make a huge difference on its own. However, given that I or my staff may’ve made other such slightly less healthy food choices over the week and I also hardly got my butt off the chair, this combined caused me to maintain. At least I didn’t gain any weight either.

If we were having coffee, I’d tell you that I went to the dentist on Wednesday. Thankfully, other than slightly inflamed gums, everything was fine. I was pretty sure I’d be diagnosed with gum disease and have to be seen by the oral hygienist. Apparently not so. I was sent on my way with instructions for better teeth-brushing and flossing and an appt with the prevention assistant in February.

If we were having coffee, I would share that I texted with my sister this evening. I can’t remember whether I shared before that she’s pregnant again. She’s expecting another girl in May. So far, all seems to be going as it should be. My (other) niece (other than the bump, I mean) is doing okay too. I mentioned in August that she was diagnosed with hip dysplasia. After surgery in September and a cast for several months, she’s now doing pretty well again.

If we were having coffee, lastly I’d share that my husband is off work with the flu. He tested negative for COVID, but thankfully he wasn’t so crazy as to go back into work as soon as he got the negative test result. Back in early 2020, before COVID was known outside of China, he did go to work as a truck driver while sick with the flu. I am glad he doesn’t have COVID, of course, but regardless I’m hoping he’ll feel better soon.

How have you been?

A Productive Appointment With My Psychiatrist

Posted on by Astrid

I had an appointment with my psychiatrist today. Last week, I had already raised some issues relating to my medication with my nurse practitioner and asked to see the psychiatrist about them.

Among other things, I finally dared to ask for them to consider lowering my aripiprazole (Abilify) dose. I have been on this antipsychotic for nearly twelve years and on my current dose of 30mg, which is the max dose, for about five or six of those years. I have had the wish to lower my dosage for years, but was always asked to wait for a while to stabilize. Now that my one-on-one has been approved for the coming two years and I’m relatively stable, I thought further waiting would be senseless.

My psychiatrist today proposed to lower my dosage in steps of 5mg each, while remaining on a new dosage for three months. She claims that the first two weeks, I won’t see any effects of the lowering of my dosage so any change in behavior doesn’t count as a sign that my dose needs to be upped again. When I wrote in a Facebook group about my lowering my aripiprazole, I was met with surprise at the slow taper. Indeed, I’m not sure where my psychiatrist got the idea from that the first two weeks don’t count, since aripiprazole has a half-life of about 72 hours, not two weeks. However, since I don’t suffer with any major side effects, I don’t see why the slow taper would be bad.

My psychiatrist said that we won’t have a goal dosage in mind, so we’ll keep tapering until it’s no longer the right thing. Yes, even if this means I can do without aripiprazole altogether eventually. I was a little shocked when she mentioned the possibility that I might not need my aripiprazole at all at one point. Of course, given the slow taper, this will take like 18 months or so, but I don’t mind.

I won’t start my taper until next month, because first we decided to increase my topiramate (Topamax) by yet another 25mg in the evening. Then I’ll be taking 50mg in the evening and 25mg in the morning. This is still a pretty low dosage even for trauma-related symptoms. It is hoped that, by doing this, we’ll help reduce my night-time anxiety even more and I won’t need my PRN quetiapine (Seroquel) anymore. After all, that wasn’t helping with my anxiety really. I originally got my quetiapine when I was still experiencing a lot of overload-related irritability. Now it’s more anxiety and PTSD that’s causing me to feel strong distress, so topiramate may be a better fit. Of course, topiramate is a daily medication, but if it can prevent me experiencing significant distress, I’m willing to try it.

I do feel a little weird, in that I was always taught that medication isn’t a substitute for coping skills or support and at the same time that it’s either one or the other. I mean, even Dutch care funding regulations at least used to say that if someone was medicated for something, they no longer qualified for support in this particular area. My psychiatrist today called medication a “chemical nurse”, in that a nurse’s role is to help calm you down when in crisis and that’s what meds do too. Now that I have the best human support I can get, I think it’s time to figure out the best medication I can get too.

Lastly, we discussed my getting medication specifically in prep for dental treatment. I explained that, after getting seven cavities filled without anesthetic many years ago, I have pretty bad anxiety but it shows itself in freezing. We decided I could take lorazepam (Ativan) 2.5mg the morning before the procedure and then when leaving (the surgery is about a 45-minute drive away), I could take another 1mg. The psychiatrist said I could skip the 1mg if I was feeling really drowsy, but my staff said the dentist can deal with me even if I am.

Overall, I’m pretty satisfied with the results of this appointment. My nurse practitioner should have sent the prescription for the increased topiramate to the pharmacy and that should be filled next week.

An Eventful Wednesday

Posted on by Astrid

Hi everyone on this Wednesday evening. The weather was beautiful today. It was cold in the morning, but sunny and about 21°C in the afternoon.

This morning, I had an appointment with my community psychiatric nurse. I hadn’t seen her in four weeks, as two weeks ago she had had to cancel due to a crisis situation. This time, I was able to talk through some of my struggles. I vented some of my grief with respect to my blindness. I ended on a positive note though, sharing the wonders of VoiceOver Recognition.

At 1PM, I had a quick dental check-up. The dentist comes to our day center four times a year for these, so I didn’t have to travel. Thankfully, all was well and I was literally gone within minutes.

Then I had a talk with my support coordinator about my upcoming care plan review. We had to discuss my risk inventory. This is a long list of possible risks someone can experience, such as of choking, falling, epileptic seizures, aggression, etc. With each box, the staff have to tick of “Yes” or “No” and if yes, elaborate on the risk. I disagreed with several “No” answers, but then my support coordinator explained that this is within the current care situation. For example, there is no risk to my personal hygiene because my staff are there to help me with this.

I did get my coordinator to add a “Yes” to risks re social media use because my Internet use can often trigger me and lead to meltdowns. I did ascertain that these risk assessments are not necessarily associated with restrictive measures. In other words, just because there’s a risk associated with my Internet use, doesn’t mean they need to restrict my online activity.

Later, I realized there really needs to be a “Yes” in the box on risks associated with overweight too. I had said this at the meeting but my coordinator had said that since I don’t suffer with sores due to fat or the like, there’s no risk. I do feel there is, given that my BMI is above 30 and I need support in maintaining a healthy’ish diet.

I went on three walks this afternoon and evening. On my way back from one of them, my one-on-one asked me whether I wanted to photograph the chickens near the day center. A client at another care home here has always wanted to have chickens and he finally got his wish granted a few weeks ago.

Unfortunately, only one of them lays eggs so far. The guy whose chickens these are says the other one’s crest needs to get redder before she will lay eggs. My husband said it might actually be a rooster though. I hope not.

Gratitude List (March 5, 2021) #TToT

Posted on by Astrid

It’s Friday again and I badly want to write. I’m feeling quite distressed by emotional flashbacks right now. To turn my mood around, I thought I’d do a gratitude list again. As usual, I’m joining in with Ten Things of Thankful (#TToT).

1. I am grateful to live in a care facility. I feel very insecure about my living arrangement right now, but my staff reassure me that I don’t have to leave. I am so extremely grateful for my staff’s patience with my anxiety!

2. I am grateful my staff make sure someone comes to sub when a staff is ill or has other obligations. Today, my day activities staff had to leave unexpectedly at around 1PM, but the staff made sure someone came to take her place. In the psychiatric hospital, we’d just be left with fewer staff if this happened.

3. I am grateful for chicken Siam. A fellow client and staff cooked that up for this evening and I totally love it! This client can’t have the cashews that normally go in, so there’s more left for me. 😉

4. I am grateful I got my second shot of the vaccine yesterday. I am also grateful that I didn’t experience any side effects. In fact, I hardly even felt the needle go in, so worried at first that they were doing something wrong. I try to trust that I got the vaccine correctly though.

5. I am grateful for God’s presence in my life. I have been extra involved with my Bible reading lately. I am grateful I finally figured out how to bookmark, highlight or copy verses in the YouVersion app and how to add notes or prayers.

6. I am grateful for all the lovely treats the staff who left our home last week, left for us. We had winegums, candy bars, ice cream and more.

7. I am grateful for no rain this week. It’s cold outside, but usually sunny. For this reason, I was able to get in over 10K steps each day of the week so far (not counting today, but I will later).

8. I am grateful I’m done with dentistry appts for at least another several months. My experience at the dentist’s was pretty bad last Tuesday, by no fault of the dentist. Let me just say I’m glad I’ve got it over with.

9. I am grateful I got to talk to my parents on the phone on Monday and that they are well. I had a nice chat. I will need to phone my sister later too. My parents were going to visit her and her family on Tuesday.

10. I am grateful for the ability to chat to other clients, including those from other homes within my care facility. I chatted some with a guy from the home next to us while we met outside of the day center a few days back. We used to go on walks together with the staff and also have coffee at each other’s homes, but due to COVID restrictions we no longer can. I am looking forward to being able to hang out more with him and other clients once the restrictions are lifted.

Wow, this turned out much better than I expected and it certainly did help.

What are you grateful for?

A Very Intense Tuesday

Posted on by Astrid

Wowah, it’s been quite the day! I awoke at 8AM from a nightmare. Thankfully it wasn’t about my current care facility. I got weighed in. Thankfully, despite all the treats the staff who left us left behind, I’d only gained 200 grams.

I then got dressed, got breakfast and then read some. When my day activities staff came, she said the hairdresser was here. Like I said last week, hair salons are allowed to open again, though I overheard a staff say this isn’t until tomorrow. Oh well. I don’t go to the hairdresser each time she visits the care facility, so wasn’t sure I’d go this time, especially at such short notice. I eventually decided to go anyway and she cut about 5cm off my hair.

Then I went for a walk. Once back home, I had to eat, because I’d have to leave for the dentist at noon. I wouldn’t have my appt till 1PM, but it’s about a 45-minute drive to the care agency’s main institution, where the dentist is.

The staff had only told me of my dentist’s appt yesterday, presumably so I wouldn’t worry. I didn’t really, but my anxiety went through the roof once the dentist was doing his job, despite my having taken a PRN Seroquel to calm my nerves. It wasn’t noticeable to the staff, as I practically froze.

I had to have two cavities filled. Both were underneath an existing filling. Despite the topical anesthetic, it did hurt a little. To be honest, one of the teeth still hurts. I also got some protecctive layer over one of my other teeth, which had receding gums and for this reason the root had become exposed. That thankfully didn’t hurt.

Once I was back at the care facility, I tried to rest, but couldn’t. The anesthetic was wearing off and it hurt pretty bad. I decided to do some reading. Then the orthopedic shoemaker visited. He had tried to widen my shoes, so that my AFO (ankle foot orthosis) and arch support both fit into it and I would still be able to get my foot into the shoe. It worked, so now I can start practising walking with my AFO in. In fact, I’m pretty sure I won’t have to practise, as the discomfort is already manageable.

Once the shoemaker was gone, it was time to have dinner. I then had a bit of a meltdown over dessert, or maybe because of the reason it was just a spoiled tantrum. I eventually calmed down though and was able to enjoy the rest of the evening.

I finally gave in and got myself a membership to the International Association for Journal Writing (IAJW). I was a member some years ago, but at the time rarely used the member benefits. Part of the reason is that I didn’t know how to work Zoom and the get-togethers are on there. I still don’t know how to use it, but I think I’ll learn quickly enough.

Now it’s past 8:30PM. I’m not tired yet, but maybe I should have an early night anyway. Tomorrow, my community psychiatric nurse will be here at 11AM. That should go okay. Overall, I’m doing pretty well.

Dentist’s Appointment

Posted on by Astrid

I shared last week that I was going to have a dentist’s appointment soon and was really nervous. I reluctantly agreed with the care facility physician that 1mg lorazepam the night before and 1mg about an hour before my 8:30AM appt should help me enough. It for sure must’ve helped some, but I was a little disappointed in how much of the edge it took off.

I had my appointment today. Went to bed at 8:30PM yesterday evening to hopefully get a good night’s sleep. I didn’t. I half-awoke at least eight times before finally waking up at 4:15AM and not getting back to sleep.

Still, I was calm’ish on the way to the dentist’s office. My dentist’s practice is at the main institution for my care agency in Wilp, which is a 45-minute drive from Raalte. I had fully expected to fall asleep in the car, but I didn’t.

I still didn’t really know what to expect, even though I’ve had a lot of cavities filled before. This was an old filling that needed replacing, so that should be easier. It wasn’t. I did get a topical anesthetic. That reminded me of why I hadn’t had it when I had seven cavities filled at age eighteen. The anesthetic is really, well, weird. I really expected the injection to hurt, but it didn’t. Instead, the feel of numbness and thickness was more annoying.

I was really anxious all throughout the procedure, but had no idea how to make it clear. I mean, my day activities staff was with me and she held my hand, but she apparently didn’t feel me pinching it. Then again, what could we have done anyway?

I had one filling replaced and a new cavity filled. It also turned out I have a pretty bad mouth ulcer near the tooth that needed the filling replaced. That will need to go away on its own. I will need to return in April to get some fillings on the other side replaced.

Now we’re twelve hours on and I do have some slight pain still, but it’s manageable.

I’m just trying to relax this evening. Had a pretty good day overall today. Having lunch with the anesthetic still wearing off, was kind of hard, so we chose to move the Tuesday morning cooking activity at day activities to the afternoon. The tortilla wraps were delicious!

Taking a Risk

Posted on by Astrid

Today I’m joining in with Five Minute Friday (FMF). The prompt this week is “Risk”.

Last month, like I shared in passing on this blog, I finally opened up to a behavior specialist at my care facility about my struggles. I was really putting myself out there. In my mind, I took a huge risk, because I felt that if I was open about what I really needed, I’d be kicked out of the care facility. I wasn’t.

Then two weeks ago, as I discussed my issues with my community psychiatric nurse (CPN), she started to suggest I live in an apartment building for autistic people. That didn’t sit well with me. I mean, I don’t care who my fellow clients are as long as I get the support I need and I won’t get that in an apartment building. I mean, of course I do somewhat care about my fellow clients, but not in the sense that I need to be able to get along well with them. They aren’t my friends, after all.

I still feel I’m taking an immense risk by opening up about my feelings. I did so again last week, when I asked the staff at my facility to ask the physician for a script for some tranquilizer. The reason is that I’m due to have an old filling repaired at the dentist’s next week. The area surrounding the tooth is already inflamed and I experience considerable pain from it, so I know it’s going to be hard going in and having it fixed, despite the option of getting a topical anesthetic.

So I put myself out there again and asked for something to calm my nerves. Initially, the doctor told me to take 0.5mg lorazepam. Well, that’s not going to work. So I felt off again, like I was being a drug seeker and a burden. I’m used to being seen as a burden, after all.

Being genuinely open about my feelings, my needs and even my wishes is a huge accomplishment for me. I’m totally used to being judged. After all, if people really see me, aren’t they going to discover how wicked I really am? Apparently not.

Attachment Issues and Other Ramblings

Posted on by Astrid

Hi people, how are you? I hope you’re doing better than I am, as I’m basically feeling pretty crappy. I tell myself I need to enjoy the good moments, good days even, here in the care facility. I believe that if I don’t feel happy here, then the staff could just as easily kick me out and make room for another person. I know paradise doesn’t exist, so can’t I just be happy with what I have?

That’s not the problem though. I’m not looking to leave this place or thinking I can have a better life elsewhere. I can’t. But still, I’m unhappy at times. Then again, isn’t everyone? And yet I beat myself up over it, which leads to more unhappiness, which leads me to beat myself up even more.

At the root of all this seems to be a deep-seated belief that there’s no place I’ll ever fit in, and if I do believe I fit in, the staff won’t agree and will kick me out. I feel as though I have to prove that this place is perfect for me – which it isn’t, of course. But it’s as close to perfect as can be and that’s enough for me. But is it for the people around me?

Last night I barely slept for two hours. At 5:30AM, I accidentally sent out a video call to my husband while trying to distract myself. He called back almost immediately, as he was at work already. He assured me that he doesn’t want to get rid of me and my staff don’t want to get rid of me either. I was happy enough with that that I could sleep.

This morning, a relatively new to me staff woke me up. She asked whether I’d manage getting started on my personal care. Normally, I get some help on Wednesdays, but I was too tired or confused or scared to ask her for help, so I just went about doing my morning routine. I was feeling pretty out of it, but I couldn’t explain.

The rest of the day was okay. I went to the dentist this afternoon for a check-up and because I’ve been having some pain. I have inflamed gums, but other than that my oral health is good. I was told I brush my teeth well, something I attribute to the electric toothbrush my husband gifted me for my birthday. Now I will need to use toothpicks too. One filling that I’ve had for like fifteen years needed replacement, but that will happen at my next appt.