Couch 230: Decent Communications

Unfortunately no. I live in a mostly rural area and in the next couple of years our hospital is actually closing down. They don't meet earthquake standards so they are going to move about an hour away. But it doesn't have an IOP or IP anyway. When I was IP it was about 2-2.5 hours away. I've looked at a couple of IOP but they are all about 2 hours away or more which means I'd have to leave work in the middle of the day which means I would be working essentially part time (less than 30 hours a week) which I can't really afford to do right now. Maybe next year when I have some more debt paid off I could swing it but right now I really need to be at work 40 hours a week. I'm sure my work would give me the time off, or at least I'm pretty sure, I just can't afford it. My case manager looked into it last year and talked to my pdoc about it. He was like, she really needs one that is specific to self harm. And my case manager looked and couldn't find one within a three hour radius from me. My case manager this year who is different from last year hasn't brought it up but I could ask her to look into it to see if there is anything closer to me than there was last year. Because if I just had to leave like two hours early three times a week or something I could probably swing that. Thanks for the thought though. I appreciate all the help couchies!

The IOP I did last fall was conducted entirely over Zoom. Not saying that's the ideal situation, but it might be an option to consider and look into.

Hey Kit,

Do you feel grounding techniques could help you? I dissociate tons, so I use them. Some people use self-harm to cope with dissociation, I used to.

I pick grounding techniques from this list: Grounding 101: Featuring 101 Grounding Techniques! — Beauty After Bruises

I agree with Lemoncake, you need (imo) much more support than you've been getting for a long time. Dr K seems really ignorant about self harm. Seriously! Since when has "wake up and not do it" helped? Ugh.

I had a bit of an embarrassing bike spill this evening - two women were on the path and not moving over so I tried swerving but off the path was a big tree with big roots - flew right over the handlebars

I am so tired of people (who have no excuse not to, like being elderly or injured) not getting out of the way of others.

And also the people with the SUV version of strollers taking up the whole sidewalk.

I hope they stopped to help you.

You know those "thanks" are really hugs, right?

Hush yo' mouf!

Update:

Still in pain. I just took another 1000mg paracetamol (Tylenol) and 400 mg ibuprofen (Aleve).

I have Etoricoxib 120 mg (Arcoxia) from my previous wisdom teeth surgery. Google says it is a selective COX-2 inhibitor used to relieve moderate post-surgical dental pain.

I don't know if I can take it but the pain sucks. I rather not risk accidental overdose though.

I went to the gynaecologist my friend recommended, another friend helped me pay two third of the bill. He's an experienced guy, used to work in the hospital that public health would send me. Clinic even has ultrasound equipment.

Nothing physically wrong with my bits. He seconded my psychiatrist's opinion on how stopping periods as much as possible is necessary. Didn't have to disclose gender dysphoria. The mood issues and pain (not just premenstrual) can trigger suicidal thoughts. Glad my psychiatrist isn't like my former psychiatrist...

Discussed options, he recommended I go back on the combined pill (estrogen and a progestin) but through public health because I told him I switched to Depo-Provera for cost. He said to stay on Depo-Provera until I get an appointment. Also wrote a memo and attached ultrasound images which should help at the appointment.

No idea how long the wait will be but I put in an online request already.

I'm sorry you're still in that much pain, QM. I'm glad you were able to get checked out by a doctor. Hopefully you can get the combined pill soon and that it will help--I assume you'd take it continuously (no placebo pills) to avoid getting a period?

Yikes, hope you're ok stopdog!


Hugs QM, i'm sorry you're still in so much pain and hope that you can get on the combined pill soon & that it helps!

Not sure quite what's gotten into me lately. I volunteered to assist with web calls for an hour this morning, that's the 3rd time this month I volunteered when they asked for help. Actually I guess I do know. It's the culture ambassador thing, and that they asked instead of told (considering it's not part of our normal job) - and also either specified for how long or let us decide how long - that goes a long way with me. I'm all, I can do anything for an hour! All you have to do is get one chatty person and let them talk and that can easily take up 1/4th of the hour! haha. I ended up taking only 3 calls and I was able to help each of them so that felt good.

I'm claiming today as a Good Day. I went to my watercolour painting class, and had the opportunity to see the work I've done over the last couple of classes laid out all together.

Knowing that I can be that productive helps.

Not pictured - the intricate Taj Mahal image that is likely to continue giving me a headache, until I figure out how to capture it to the best of my ability.

I had to contact my pdoc today. The pharmacy keeps telling me I don't have a refill of Latuda but I don't know why I wouldn't, he always sends three at a time. But I did see him a month early last time (because I was in crisis) and so he might have thought I had one from then which I asked the pharmacist about and she said I have one but it is for 40 mg not 60 mg. So now I am confused as to which one I am supposed to be taking. I literally have no clue. So I called the doctor's office and got the voicemail and left a message which I am sure he is going to roll his eyes at because how can I not know what I am supposed to be taking? But if he did change it to 60 and only gave me two refills (I see him every three months unless I have a crisis) then he should have caught that. I'm a little frustrated right now because I think I have two pills left and since starting the Latuda along with the Rexulti I haven't been having as many hallucinations but if I run out then I'm worried the hallucinations will come back. Last time I had an issue with my meds he got back to me the same day. But sometimes he goes hiking and camping in the woods and is out of cell phone range. I've had that happen too, where I was at the hospital and they couldn't get a hold of him to get his impressions on whether or not I should be IP.

So, I tried to make a sooner appointment to see my T. Turns out he only works twice a week and it's Monday and Tuesday. He is booked next week and I am scheduled to see him the following week. So she put me on a cancellation list for next week but I'm not holding my breath. So I went from a T who saw clients/patients 1 time a week, to a therapist who sees clients/patients 2 times a week. Boy I know how to pick them! I'm not sure what I am supposed to do in the meantime. I do have an appointment with Kayla, my case manager, next week so I'll have that. I texted one of my support people but I don't know how helpful that was and another one of my support people it's her birthday so I don't want to bother her on her birthday, which leaves my third support person who I haven't contacted yet. Hmmmm. Mental health care in this area leaves much to be desired!

I'm sorry, Kit. If you're willing to do virtual, could you look at other areas in the state? Though not sure if anyone would be able to get you in next week or not. And would your former T (the one who works Saturdays) possibly be available? Or, I'm not sure if you'd find Pastor T helpful for this or not, but could you consider reaching out to him if you think you need more support? Or possibly something like Betterhelp (or the other online place that I can never remember the name of)?

Thanks LT. It's hard to look for a T when you are in a heightened level of crisis. It's too much to think about. I did let Pastor T know about the SH and he said the answer (to what question I don't know) is to just start again. He could potentially be helpful but I don't know that I am up for all the memorization of scripture and extra stuff you have to do with him. I could probably see former Saturday T but I'm not sure how helpful she would be. She's too scattered and half brained sometimes it drives me crazy. She's nice, she just isn't maybe the most competent. I looked at the T list that case manager Kayla gave me and some are pretty far away but I imagine some might be willing to do virtual which is what I do with Dr. K anyway. I don't even know where his office is. I know the general street but that's it. I'm not sure I'm ready for Betterhelp or 7cups or something like that because of the frequent suicidal idealation. It seems like that would be contraindicated but maybe that is my own bias. I've never tried them. I'll keep trying my support people as needed, look over the Kayla list and if I have to go into the crisis walk in center though I am loathe to do that because there are always people messed up on drugs there and it's not a restful sort of place. But they do let you stay for 23 hours. So it's sort of like expedited IP. And then of course I have you guys! Who would have thought I would have picked a T that only works two days a week after having picked a T that only worked 1 day a week. I wish former T (not Saturday T) would take me back. That would solve all of my problems. Except for all the transference. Ha.

I think he probably means “start another streak of not self-harming again.”

I don’t know how you do it (and I’m not asking in case it triggers anyone) but whatever it is, perhaps remove easy access to it.

Also, Kit, if you don't hear back from pdoc, could you just refill the lower dose of your med? I'm not sure of its form--if it's a capsule, you probably couldn't do this. Or if extended release. But if a regular tablet, maybe you could take one and a half. Or at least taking the lower dose could maybe help keep you from any sort of withdrawal symptoms until you can get in touch with pdoc.

Yup, continously without placebo pills. Come to think of it, I've never heard of them having placebo pills in my country, but am highly aware the USA and some other countries have them. Wonder why.

Doctors here (who aren't gynaecologists lol!) can have different opinions on the "necessity" of periods. I've had a GP and my former psychiatrist tell me it's needed or there would be a “backlog” or that no periods is bad for health.

Thankfully my psychiatrist understands having a period or breakthrough bleeding with cramps, wrecks my well-being. The gynaecologist was like "Yep, your psychiatrist is right to tell you to see a gynaecologist."

I've learned that I'm not "over dramatic" when I say my period gives me suicidal thoughts, intense irritability and anger (which affect relationships!), and a ton of physical pain. That it's a medical problem that deserves to be taken seriously. Even if it doesn't really fit PMDD because it happens during my period.

After (long-distance) BF and I watched TV and video chatted last night, I sent him a text message about how it's hard being apart and I miss the emotional intimacy that was so easy when we lived together. I wondered if we could maybe try to talk about more stuff when we video chat, like maybe he could tell me more about his life before we met or something like that. (I texted this because I wasn't sure how to say it right verbally.)

He "loved" the messages and texted me a "good morning" message and sent "I miss you" gif and played his turn at Words with friends. But he didn't reply, which just like, come on dude. I don't want to bust his 'nads or like be an annoying GF or whatever, but if we can't talk about stuff then this isn't gonna work.

I dunno how to reply; obv I won't start with that last sentence I just wrote here, but I'm trying to find the balance between haranguing him and stating my wants/desires. I'm also trying to work out whether or not this will work... what I actually need (love, respect) vs what I may or may not need (long talks about warm fuzzy stuff) vs things that would be nice but are not deal-breakers (performative hair).