I’m starting a program tomorrow at my local hospital
It’s teaches coping skills for people with anxiety and depression
It is half days on Tuesdays and Fridays for 12 weeks, with a minimum of 5 Thursdays
It is a group format, run by a Social Worker, Registered Nurse and Occupational Therapist and overseen by a Psychiatrist
I’ll have a primary worker and access to the Psychiatrist during the program
At first, I was really intrigued and almost hopeful
Until I went for the info session
It was a few weeks ago
It was run by the OT who was jet lagged and seemed like she hadn’t a clue in the world of what she was talking about
I felt some of my balloon of almost hope deflate
I then went for an assessment last week with the RN, who sat impassively while I cried as she asked questions from her computer
I felt foolish and disappointed when I found out she would become my primary worker
I was accepted into the program and given a start date
Tuesday March 26
I’ve promised myself that I will give it an honest open-minded try
After all, everyone has bad days and all that
And it would be reckless to throw away an OHIP covered 12 week program off of two measly meetings
Tomorrow, I’ll be there at 8:45 AM to start my first day
So maybe my balloon of almost hope won’t inflate
But maybe my ballon won’t pop either
For right now, that’s good enough
I’m feeling frustrated today
I consider myself a pretty smart person
Also someone who is more self aware than the average person
I’m well versed in all things anxiety and panic related
I feel like I graduated with a masters in this shit
I can recite all the therapy talk
I actually believe in what I’m saying
I am perfectly aware that nothing worse than the panic attack itself, will happen to me
Every morning I wake up, heart pounding, mind racing
In fear of the next panic attack
Those same panic attacks I’ve been having for over two decades
Those same panic attacks in which what I’m most afraid of, does not come true
It never comes true
So what the fuck is the problem?
I think my own fear is greater than my knowledge
So I give in
Day after day
Even with the meds I obediently take
I watch life pass me by
Feeling less and less like it’s even my life that I’m missing out on
That’s how far out of reach things like dinner out or going to my sisters house seem
I can’t seem to stop from being hard on myself
I feel like yelling at myself:
‘AFTER ALL OF THIS, WHAT THE FUCK DO YOU STILL NOT GET?!
HOW MUCH MORE TIME WILL YOU WASTE BEFORE YOU FINALLY MOVE ON?!’
I’m sitting here shaking my head
Because, after everything
And I still don’t have the answers to any of that
Its been three weeks since I slept in my own bed
It’s been one month since I went to the first emerge
It’s been four weeks and two days since I spent a night in a crisis centre
It’s been four weeks and one day since I went to the emerge in Collingwood
It’s been three weeks and two days since I sat in my neuro psychiatrists office crying and begging for help
It’s been three weeks less a day that I went back on 40 mg of Paxil
It’s been three weeks of good days, bad days and horrible days
Its been one day since I saw my neuro psychiatrist again and he upped my dosage to 50mg of Paxil to get me through this ‘crisis’
It’s been one day since he told me there was a significant gap in the mental health system which is why my wait for OHIP covered CBT is taking so long
Its been one day since he gave me the info of a private clinic
Its been thirteen hours since I started my new dose
It’s been thirteen hours with my stomach in knots
It’s been thirteen hours of fears, what if’s and so much more hope than I ever thought I had
One day at a time never felt quite so long
I know I’m not patient
But I’ll keep waiting if it means I get even a small fraction of a happy ending
I’ll keep waiting if it means that the last month hasn’t been in vain
I’ll wait as long as I can keep finding shards of light in the darkness
I’ll wait even it’s just a flicker
I can’t help but worry
I can’t help but wonder how long the world will wait for me…
While I’m glad to see so many friends and family supporting Bell’s ‘Let’s Talk’ campaign to raise awareness for mental health, I think it’s long overdue time to get real about fact that while awareness is helpful in de-stigmatizing mental illness. It does not fix a very broken healthcare system. Yes, I know the rhetoric. Canada is so great, free healthcare and all that. But <and this is just my opinion> it’s great when you are for the most part a ‘healthy’ person. For the rest of us, navigating the healthcare system with a chronic illness like Multiple Sclerosis is, at the best of times, tricky and underwhelming. However, when you throw mental illness into the mix, it becomes glaringly apparent just how lacklustre our services really are. Firstly, when a person is in crisis, you do what you’ve been taught your entire life to do…which is to seek help. You go to the emerge. Where you are triaged based on need.
Which I understand as the most serious cases being seen first.
So in my last experience, I waited and waited and waited. In active crisis. Which for me, meant I felt panicked and somewhat hysterical.
And they put me to wait in a loud, bright, bustling waiting area for over 5 hours until I approached a nurse and through sobs told her I needed help. She moved me to a stretcher in a quieter hallway. I waited and waited and waited.
After a few more hours, I was seen by a crisis psychiatric nurse and a psychiatrist. I was ultimately sent home (with no follow up) because the psychiatrist didn’t want to ‘step on’ the toes of my illustrious neuro psychiatrist.
Clearly, my crisis had not ended. I ended up seeking help twice more <once through a crisis centre and once more at a different emerge>.
So let’s stop here for a minute.
What could be changed to keep in line with the current fad of progressive mental health Canada seems keen to have?
1. Upon first triage, when I explained that I was experiencing panic attacks and was terrified there are a few different ways that could have been handled:
Option A. A triage system that recognizes mental health. My vitals could still have been taken and when it was apparent that my panic attack was the primary reason for my visit, I could have been triaged to a mental health waiting area. This might look like something on a different floor, with room for privacy and staffed by both nurses and psychiatric nurses. I could have had the psychiatric nurse assess me and then had a psychiatrist who does the rounds discuss with the nurse what the best course of treatment would be. I would not have a psychiatrist who cared more about her career connections than my crisis.
Option B. Upon triage, after taking my vitals and confirming that it was in fact most likely a panic attack that was my primary reason for visiting. I could have been provided with crisis line information and/or a referral to a mobile crisis team or something similar. In my own work experience, I have used a mobile crisis team to come to a school I was at with a young man who needed psychiatric assistance. Often with anxiety disorders, talking to someone who has the tools to walk you through a crisis, is all you need at that moment.
Option C. Would require intensive training for all frontline staff including triage nurses to emergency room nurses to emergency room doctors and so on. I would imagine this option would be highly unlikely. However, it would be helpful for such staff to be experienced in noticing the signs and symptoms of various mental illnesses and being knowledgeable with basic tools such as belly breathing. Furthermore at the point of triage, redirecting patients who have a flu or a cold to walk-in clinics would help possibly reducing the amount of people using the emergency room.
Secondly, family doctors generally are not equipped with the resources to handle crisis situations. And in my case, my doctor has something like 1700 patients. So if in my crisis, I had called to get an appointment to at least know there might be relief in sight, it is unlikely that I could get an appointment within the next two weeks. So this appears to be dead end and not a valid or helpful direction.
Thirdly, the saga with my neuro psychiatrist. You remember him right? The one no one would touch me because of?
I was called for a referral that the psychiatric nurse had put in for a short term psychiatrist.
When I spoke to intake, she said they could not see me because of my neuro psychiatrist.
I asked perplexed ‘even if I’m telling you I don’t want to go back and see him?’ You can guess the answer there.
So my neuro psychiatrist. I left voicemails and emails and was lucky that I had an already scheduled appointment with him the week after my emergency room visit. I saw him for less than half an hour, I gave him notes that I took on my ordeal which I’m sure he never read.
He apologized to hear what I had gone through and recommended that the next time I tried to get off Paxil, he would do it inpatient at Sunnybrook.
I think I guffawed and said I’d never try to get off of it again.
He prescribed my original dose of Paxil and some additional Ativan to get me through, told me to call to update in two weeks and sent me on my way.
Oh and my next appointment is in three months time.
While he is a very highly regarded doctor and widely known within the MS community, is he the best person to be treating me? My anxiety and depression were triggered long before my MS appeared. It appears to me that seeing another psychiatrist is near impossible not to mention that all psychiatrists are OHIP covered, so the wait time for a new one would likely be close to a year. In October, my neuro psychiatrist put in a referral for me to do CBT at a hospital close by. The wait time for that is equally lengthy. So I found a private clinic that offers CBT that is not covered by OHIP and am going to see them next week. It’s expensive and not covered by my group benefits.
During this time, I also had my family doctor complete an application for a private inpatient facility that deals with mental illness and would cost approximately 20K for 56 days.There was a wait time, and thankfully during this time, my Paxil increase has kicked in and I am no longer in crisis so I have deferred admission. I do not want to go to a place that costs that amount of money. I am trying to figure this out on my own before they call me to give me a final offer me for admission.
I don’t know where that leaves me.
I don’t know where any of this leaves me.
I don’t know what my future looks like.
Much like half the Canadians who also live with mental illness.
We are left to navigate this scary and overwhelming path on our own.
So maybe it’s time Bell changes it’s campaign from ‘Let’s Talk’ to ‘Let’s Talk About How We Can Do Better’.
Dear David (from Gerstein Crisis Centre)
It’s taken me four days to finally be able to compose this letter.
Not because I didn’t care to but because I became too emotional whenever I thought about your kindness towards me during my short stay at Gerstein.
You were the first person during my ordeal who did not see someone who was ‘weak’ and ‘needy’ but instead you saw someone who was tired of fighting so hard.
Someone who just needed a safe place to land.
You gave me that.
From the very minute I stood in front of the office doors as a crying hot mess, until we had talked long enough for me to enter a sleep-like.
You threw me a lifeline.
You made me feel heard and understood, and there are not simply enough words in the English language to convey my complete gratitude towards you for that.
So from one panic attack sufferer to another…
In words I know you’ll understand best.
I’ll just say:
I’d lay down in the snow with you, until your panic attack passes. 😊
PS if anyone knows him or how to get in touch with him let me know
Mornings and late late nights are my worst
So far, I’ve made it through 7 mornings and 6 late late nights
Though it felt more like months of both
My body is tired
From ingesting little more than diabetic meal replacement drinks
And the occasional PB and J sandwich
I never thought it could get so bad
I never thought it would get this bad, again
Although it feels new to me
In many ways I’ve done this before
From calling crisis centres to emerge visits and drinking meal replacers and med changes
I guess I should say
I hoped it would never get this bad again
I know the old adage of ‘that which does not kill us, makes us stronger’
But I think I’d be fine not being tested for the millionth time on my strength
I think I’d prefer something like
‘You’ve been through the worst, it’s all sunshine and meadows ahead’
I’d even settle for something like
‘Way to go Angela!
It’s all overcast and fields of manure with the occasional sun shower ahead.
I could settle for that