Appointment With My CPN

Yesterday, we had an appt with our community psychiatric nurse (CPN). I can’t remember all that we discussed. I went into some detail about our sadness and overwhelm over the last few weeks and explained that we had signed a letter to the manager requesting more help.

I tried to ask my CPN to get me an appt with the psychiatrist to discuss my meds, as my overload and irritability are increasing. While I was trying to get this out, I constantly heard someone in my mind say I shouldn’t be asking this as it’s attention seeking or drug seeking or whatever. I don’t even want a med increase per se. In fact, I’m at the maximum dose for both my antipsychotic and antidepressant already. I might want something to help with sleep and especially the restless dreams/nightmares. I feel intense shame about discussing that though, as my nightmares aren’t your standard PTSD nightmares. In fact, my trauma isn’t your standard PTSD trauma.

That is another issue I’m facing. Yesterday, I read an elementary school friend’s story of child abuse. It triggered me to an extent, because I can relate. Still, my trauma wasn’t that bad. She is a child sexual abuse survivor. I am not. Though I endured some physical abuse, it wasn’t that which caused my complex PTSD and dissociative symptoms. The most significant trauma in my life was the emotional abuse and neglect.

Of course, I just told another survivor that childhood emotional neglect and emotional abuse can cause C-PTSD and dissociative disorders too. In fact, dissociative disorders are largely attachment-based, so anything that disrupts normal attachment, can cause it. Still, to apply that knowledge to myself, is quite a bit harder.

I eventually did ask my CPN to refer me to the psychiatrist. My nurse practitioner would normally prescribe my medication, but he does consult with the psychiatrist also. Besides, I’ve never even seen the psychiatrist. So my CPN was more than happy to get me an appt.

Early November 2020 Health and Wellness Update

Like I said a couple of weeks ago, I had a physical health check-up at the mental health agency. That wasn’t good. That is, my blood pressure was high and so was my weight. Even though the nurse said I might not have gained any weight compared to the last time I stepped onto the scales, as each scale is different, I was pretty alarmed. So was my husband. He asked whether I could be put on a diet. Well, no-one can force me, but I did agree on a food plan with the staff.

Now we’re a little over two weeks on. I didn’t get my blood pressure taken today, as my GP recommended we wait three months and then check it everyday for a week. I did get weighed in though. And guess what? I lost 1kg compared to the last time I stepped onto this scale in early September and 3kg compared to the health check. Only two more kilograms to go and I’m no longer obese.

Overall, I’m doing okay sticking to the food plan. I eat bread rather than crunchy muesli for breakfast, make sure I eat enough veggies and fruit and drink at least 1.5 liters of water a day. That plus coffee, which contrary to common belief does hydrate the body to an extent, and occasionally green tea. I do usually eat a cookie with each coffee break, while my food plan says I can only have a cookie with my evening coffee. However, each day that I skip a cookie, I’m proud of myself for making a healthy food choice. Same each morning with breakfast, which is a real struggle, as I’m not a bread person.

I also make sure I get in enough physical activity. Last week, I felt really lazy, but, according to my Fitbit, still got more than the recommended 150 weekly minutes in active heartrate zones. This week, so far, I got 341. I broke my personal step count record yesterday by getting in over 16K steps. I don’t go on the elliptical as often as I’d like, but that’s because after walking two to three times a day, my legs are often tired.

In other health-related news, I talked to my CPN from mental health about sleep on Tuesday. I usually get enough sleep, but I have very vivid nightmares most nights. They aren’t your standard monster-chasing-me nightmares. In fact, most revolve around my sense of safety here at the care facility. My CPN may talk to my nurse practitioner about it. She said I might benefit from medication to help with this. Thankfully though, having discussed the issue has already calmed things down a bit.

Worrying: Will I Be Kicked Out of the Care Facility?

I have had a lot of dreams in which I was kicked out of the care facility lately. They’re no fun. I don’t know why I have these dreams. I mean, yes, a new client may come to my home, but I didn’t find out about that until today. Besides, my staff say it doesn’t mean I’ll have to leave. After all, there’s still an available room in my home.

Still, it scares me. I worry that, if this other client needs a lot of support, I will not get my needs met. I mean, not because of this other client, but because staff will be busier. Oh my, this sounds incredibly attention-seeking. I don’t want to need more support than I can get.

And what if this other client is very noisy? He’ll most likely be assigned to the other communal room than the one I’m assigned to. However, I think he’ll attend my group at day activities, which is already very crowded and noisy as it is. I was told they had many more clients before I came, but well, then this place wouldn’t have been suitable to me.

I talked about my worries to my former support coordinator on the phone. She told me these are just my thoughts and there’s no reason I’ll have to leave because of this other client. Then again, I didn’t get to elaborate on my worries.

I don’t want to be seen as needing too much. I was often seen as needing too much. Either needing too much or claiming to need more than I got. The two are different. The people at the first day activities I attended with this agency, truly thought I needed one-on-one support most of the time, which isn’t even what I was asking for. The staff on my last psychiatric unit thought I needed little care but was just demanding a lot out of some feeling of inadequacy that was apparently unfounded. Either way, I was asked to leave the place. With the psych ward, things were a little nastier than with the day center, but the result was the same.

I saw the behavior specialist who worked for that first day center today. That fueled my worries even more. I mean, she was extremely supportive, but didn’t really know how to handle my issues either. Then again, she never got to talk to me beyond the one time when she made sure I got transferred from the industrial activities group to the sensory group. That was a good move, but when it didn’t fully work out, I guess the manager stepped in and said he’d been accommodating enough and I would have to leave. That’s what I think will happen here too. I mean, my staff are very accommodating, but what if it isn’t enough? Will we find other solutions? Will I get even more accommodations? Or will I at some point just be kicked out? I’m very unsure and that worries me.

#WeekendCoffeeShare (January 19, 2020)

Hi and welcome to another installment of #WeekendCoffeeShare. I can have coffee again, as my flu is gone. It was gone already at the end of last week, but for some time, I still didn’t really enjoy coffee.

I also tried Optimel, which is a type of no-fat yoghurt drink, today. I initially thought it was based off buttermilk, the idea of which has me so disgusted that I don’t even want to try it. It is based off no-fat yoghurt though and it was good. If you want to try it too, I think we have some in the fridge.

If we were having coffee, Optimel or another drink, I’d share that this week has been eventful. I already wrote about it a lot during the week, as I seem to have gotten quite a bit of writing mojo back. That’s good! I also enjoy the comments on my blog and am trying to engage with you lovely readers more. I also love reading and commenting on other blogs and seeing people respond to my comments.

If we were having coffee, I’d share that the week-end was good overall. I had some nightmares again, but was able to keep them from interfering with my day for the most part. Still, I’m considering raising the issue of my vivid, bad dreams with my mental health treatment team.

If we were having coffee, I’d share that my husband didn’t have time to collect all my soaping supplies yet, but we’re probably going to sort through them another time together. I think I may order some supplies online this coming week, but am not sure. My husband and I agreed on throwing out all the ingredients, as they’ve probably gone past their expiration date and aren’t too expensive. At least not if I only buy what I need and don’t end up ordering random stuff in large quantities.

If we were having coffee, I’d share that we succeeded at getting my photo taken at the photographer’s yesterday. This is for my public transportation pass. There are really strict rules on photos for IDs and passports, but mine isn’t due for renewal for another five years. I want the transportation pass so that I can travel to my husband by train. You can get an anonymous one too, but then you can’t load discount subscriptions or the like onto it. Now I will still need to digitally apply for the pass.

If we were having coffee, I would share that my husband and I ate out at La Place, a restaurant chain we often have lunch at, yesterday evening. It was okay, but rather expensive for the quantity and quality of the food. Lunch usually is much better.

If we were having coffee, I’d be sharing that I was an overachiever according to my Fitbit yesterday. It probably says so if I get over 12,500 steps a day. I got 12,700. Today I made up for it, as I sat on my ass almost all day.

Another Crisis

As those who’ve been following along with my writing will know, I was in a bit of a crisis on Monday. Tuesday and yesterday were better, but today was bad again.

It started out with a horrible nightmare last night. I still can’t shake the thought that I’ll be kicked out of the care facility sooner or later and that was what the nightmare was about. I woke up all sweaty and fearful. I called the night staff to calm me down.

Then by mid-morning, I felt rather insecure. My day activities group is divided into two subgroups. There are three full-day staff for these two subgroups combined, plus one staff who has the short 10AM-2PM shift. Today, one of the three staff who would otherwise stay the entire day, had the short shift too. I didn’t mind as much, as still each subgroup would have one staff for the full day. Then one of the regular staff, who would stay the full day, had to attend to a client one-on-one. The would-be third full shift was a sub, so she needed help doing lunch. So at the end, my full-day staff ended up helping her in the other room and the short-shift staff was attending to my subgroup on her own. She had to help people get around, to the bathroom, etc., too, so I was feeling rather left out. Everything went a little chaotic and that led me to enter the orange phase of crisis prevention.

There are three or four phases: green for adequate coping, yellow for mild distress (this one is sometimes left out), orange for serious distress and red for crisis. I was eventually able to go back to yellow as lunch was served and I ate.

Then I wanted to go into the snoezelen® room to further calm down. However, the music, though it was my favorite calming record, was way too loud. After some time, I ended up having a severe meltdown. I wasn’t able to calm down once back at my group.

In the end, I decided to take a PRN lorazepam and go back to the home to lie on my bed. I slept for two hours straight. Now I’m back to green again.

I’m joining in with #FOWC, for which the prompt today is “Crisis”. The prompt couldn’t have come at a more appropriate time.

Dream #SoCS

I have a lot of vivid dreams. They suck at times. Sometimes they’re good dreams and I”m sad that they’re just dreams, but most times, they’re really distressing dreams. A few weeks ago, I dreamt that my husband was going to divorce me or I was going to divorce him because somehow (I can’t remember the details) my past identifying as a lesbian was getting in the way. Either I decided I was a lesbian after all or my husband got tired of me having identified as one. Or something. That dream had me distressed for days because I thought it somehow meant something. Like I was unconsciously unfaithful to my husband, which I have no intention of ever being.

Other times, I dream that I’m kicked out of or leaving the care facility. This also scares me, because I am to be very honest not 100% sure it was the right choice to go into it. I mean, yes, it’s much better for my self-care, but it does mean my marriage gets strained by my husband and me not being able to see each other as often as we’d like to or as we used to.

Last Thursday, I was in a bit of a crisis. I had been in the snoezelen® room for two hours on Thursday afternoon and as a result, couldn’t sleep. I also worried about my inability to travel to my husband each week by paratransit due to the limits on how much you can use that service. The fact that I had been in the snoezelen® room for so long and this is not the first time and I’m not sure what I can do during the day, made me think back to my old day activities. Then the fact that I cannot travel to my husband by paratransit even coupled with trains each week, made me think of leaving the facility and going back to live with him. I know this would be unwise in the long run, if for no other reason then because my spot at the old day center has been filled up already.

I E-mailed my staff at the old day center. Then I ran off. I made it to the bottom of the stairs, near the fire exit, before I realized I didn’t really want to run off. By then, the sleepover staff had heard me and called the night staff. She comforted me and I was able to go back to sleep. Back to more dreaming.

I am linking up with #SoCS.

Working On Us Prompt: Sleep Disorders

The past few days have been pretty busy, so even though I did want to blog, I hardly found the time. Now it’s already latish evening too.

Today I’m once again joining in with Working On Us, for which the prompt this week is sleep, insomnia and other sleep disorders.

As a child and teen, I suffered from insomnia a lot. I would often be awake for the whole night or hardly sleep at all. On week-ends, I sometimes made up for it by sleeping in, but I was definitely chronically sleep deprived. Though my parents sometimes suggested, and I don’t know whether they were joking, that I take valerian or melatonin, I wanted nothing of it. In fact, when I was going in for eye surgery at age seven or eight, I refused the tranquilizer they offered us before the operation. I also constantly fought the anesthesia.

When I was 20, I sought treatment for my insomnia for the first time. My GP prescribed temazepam, the most commonly-used sleep medication here in the Netherlands at least at the time. I was very scared when first using it, being that I’d not taken any medication in years, not even paracetamol.

I think that what lay underneath both my insomnia and my refusal to take medication for it, was an intense fear of losing control. I was, after all, pretty compulsive particularly as an older child and teen.

My sleep issues escalated in 2007, when I lived on my own in Nijmegen. Though I didn’t sleep less than I had as a younger person, I did suffer from the effects of sleep deprivation more. When I was admitted to the psychiatric hospital, the first medication I was prescribed was again temazepam. Then followed another few benzos and even levomepromazine (Nozinan), which is normally only used for palliative sedation.

I had to take “twilight anesthesia”, which means high doses of benzos, several more times prior to procedures and chose them over the pain that would otherwise ensue. However, I still had terrible fear when I “awoke”.

Other than insomnia, I’ve had an assortment of other sleep issues. My husband said at one point that I have hypersomnia, because I slept so much. This was probably down to a combination of medication, vitamin and iron deficiencies and lack of structure.

I am a sleep talker and I snore too. The snoring got slightly better as I lost weight last year. I’m not sure whether it’s worsened again since I’ve gained weight back up again. The sleep talking comes and goes with stress.

Lastly, I suffer from vivid dreams and nightmares. They’ve gotten a little better now that the long-term care situation is more or less settled, but during times of stress, I very often awaken in a state of shock because of vivid dreams. That is, I’m not 100% sure they’re REM sleep dreams or night terrors (which happen during stage 4 sleep). I’ve never had a sleep study done either.