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Before I post this week’s missive I just want to say a huge thank you to each and every one of you who stopped by my little blog last week and read my disturbed thoughts. I was very much of two minds whether to post anything so personal and dark, but you all were so faithful in reading what I wrote, and those who contacted me were so kind that you restored my faith in writing the whole ugly truth. I love you all, and watching the stats rise was such an enormous encouragement to me! THANK YOU!

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Written late April 2016 after my latest work contract ended; updated 20th June 2016.

“I worked my a*& off to get back, really back; harder than I’ve worked at anything my whole life. ” – Detective Marcus Bell, Elementary

…”because there’s nothing like getting back for getting better” – current WorkSafe Victoria Return To Work campaign

Getting back; it’s what everyone recommends for getting better. I resisted it for a long while in my original sick leave but in the end I found that it was true! Occupation, purpose, time consuming work; it all helps to develop an inner feeling of being better, getting  back to normal.

But, as my deepest darkest suspicions have been humming a tune all along, it’s not enough. I’m not enough. My efforts are not enough. It was a dark moment! Or two…

There have been tears, and more tears; it was so disappointing!

More doubt, more undermining of my confidence that was fickle at best, more breaking through my denial of recovery to let the truth of ongoing illness in. Then there are moments of resolution, mostly led by my husband’s sensible, problem solving , kind voice where I decide actually I will be okay; I’ll be okay, I’ll figure it out.

It’s not what I want; I think that’s obvious. If I could do anything to change it I would. I tried to see if there wasn’t any way around this decision to relieve me of my job by not renewing my contract. I spoke with the powers that be reminding them of my loyalty, commitment, long term intentions and proximity, for goodness sake, if nothing else! But I can’t fight my way out of this. Maybe I have to let it be.

Oh that so does not sit well with me. But a good friend reminds me that maybe that’s the point; maybe this is a long term play for my strength of character not a short term game for my own convenience! Ahhhh…it’s hard to swallow but maybe I need that.

So here’s the situation: the workplace I was working in when I got sick doesn’t have any obligation to me, to rehabilitate me. I was working there on a one year contract when I got sick at the half way point, and wasn’t able to return to work for any more than two mornings a week in the last 6 weeks of the contract. And that was just a desperate scramble to try to be okay enough to stay on there. I was utterly unable physically, and not even slightly ready mentally to apply for a new full time contract, the only way that I could’ve stayed on. So the contract, and with it, the obligation, ended and I went back to bed. Not what I wanted, but I couldn’t do anything about it; I just wasn’t in a state to change things. It was what it was.

So then, after another 9 months at home, I started back at work with a short term contract at the next place that would take me. They also have no obligation to me, other than to offer the same support that they would offer any other employee. They took me on when I was returning to work; they knew that, and made some allowance. But it’s not their fault, not their duty. No special exemption or workplace mentors; no keeping a place for  while me while I convalesce and struggle to get back into the swing of things. You have to compete with every other well person and that’s just how it is. And when it’s over, it’s over!

Done                     3rd May 2016

I’m overwhelmed, I’m in dismay,

The job I had, the work, the pay

It did me good, it helped me stay

Above the blue line, come what may.

 

Now it’s over, my sad reply,

Tears of hurt and loss I cry,

Feeling useless, have to sigh

For fear of dark days once again nigh.

 

It did me good, it kept me busy,

Filled my days and weeks, and nearly

Convinced me that I was now surely

“Better”, “fixed”; was I silly?

 

Silly to be believe in “health” so easily,

Of usefulness, I thought sincerely

That all was good, I did feel truly

That this was it, “I’m better, really”.

 

The routine and the structure, see,

Work and occupation the key,

Helped me build life, ABC,

From sickness to health; 1, 2, 3!.

 

I got me carried away, and planned

To stay and work, but now that’s canned!

“I have no hours for you ma’am”,

It’s over; nothing to be gained.

 

You’re done here! Well it hit me hard,

I did not see it coming, barred

From that which made my life less marred,

It feels unfair, am I so tarred?

 

By that which has my brain entangled,

Bipolar, why have you now mangled

This, above all else was dangled

Hope, that by work I’d disentangle.

 

Please let me stay, I love it here,

The colleagues; the task; the jolly cheer,

And to my home it is so near,

Please let me stay, just anywhere.

 

I’ll type the scripts, talk on the phone,

Check the work that others have done,

I’ll smile, be nice, work with anyone,

Please, please, please don’t say I’m done!

 

 

 

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“Totally incapacitated”

Here’s one of the perks of being a health professional.

When the tables are turned and I find myself on the other side of the bench/bed/clipboard, I can understand the language.

When a doctor, nurse or other health professional forgets to translate the Greek/Latin into English I still know what they’re saying.

I know the medical terms. I know the diagnostic criteria. I know the treatment plan. I know the drill.

Because it’s my language, usually.

“Take these tds. Experiencing anhedonia. Query gets elevated. Ruminating. Appropriate. BP1”

I spent years learning all the terminology so that complex medical information can be quickly and easily communicated to other health professionals. And then spent years of practice learning how to translate it back in a simple, un-involved way to patients and non-health professionals.

So now, when I see a doctor it doesn’t matter whether they use the Greek/Latin or English; I can understand.

This has its downsides.

Sometimes doctors use Greek/Latin code to communicate sensitive information amongst themselves that the patient doesn’t necessarily need to know at a point in time. Information that may have a negative impact on the patient. Information that may alarm the patient unnecessarily. Information that may skew the way the patient sees themselves and reports information to the doctor. Or many other reasons.

Patients don’t like this most times. They want to know. They want to be told. They want the translation of doctor-speak.

And so they end up asking for information that is unnecessary; that will later prove to be irrelevant; that scares them for no good cause; that gets them looking for specific signs and symptoms that may not be there and creates a degree of paranoia; that gets them reporting biased information to the doctor instead of giving the full range of  information that the doctor needs to determine a diagnosis or treatment plan.

For example a patient comes to the doctor with a dry cough that has been going on for a couple of months.

In the doctors’s mind the common causes are viral, post-nasal drip after a cold/flu, or chest infection. The less likely causes may include tuberculosis (TB) or lung cancer. But of course no doctor will tell a patient who has just walked in to the surgery that they may have lung cancer or tuberculosis. That would create panic, scare them for no reason and bias the patient to give information that they think is related to lung cancer or TB. It would create a lot of emotion that would take a long time to deal with and is unnecessary.

Instead the doctor runs through a series of questions to rule in or rule out different diagnoses and comes to a conclusion, makes a diagnosis and comes up with a treatment plan. Without causing bias or terrifying the patient by telling them the options that they are ruling in and out. Without giving them unnecessary or irrelevant information. Without telling them information that somehow they think they need to know.

They communicate the diagnosis and treatment plan and send the patient on their way.

(This is an example only and not a comprehensive diagnostic description!)

The unfortunate thing about knowing the language is that I get these sensitive bits of information. I get information that I don’t need, that may end up being irrelevant. I get information that scares me, that changes the way I think about myself and the way I look for symptoms. I get information that is more than I can handle, that weighs me down.

Here’s a translation of the terms above:

“Take these tablets 3 times every day. The patient is suffering from an inability to experience pleasure in, or enjoy, day to day life. There is a possibility that the patient suffers from episodes of mania including high energy, extra happy moods, enhanced appetite, lack of judgement and self control. The patient is experiencing circulating thoughts on the same subject that keep going around and around and prevent other thoughts. The patient is behaving in a reasonable manner and is not demonstrating any unusual symptoms. Bipolar 1 disorder, otherwise known as manic depression where a patient can experience episodes of severe depression and then alternatively experience manic episodes of high energy, excessive behaviour and ultra happy moods.”

So you can see why health professionals are taught Greek/Latin!! It makes communication so much simpler and easier. Saves a lot of talking in critical situations.

But for me, instead of hearing a few blah blah words, I get the whole lot dumped into my brain. Which is a lot of information. Especially about things that aren’t confirmed and are only a “query” or possibility. It changes the way I scan myself and look for symptoms. It changes the way I think about myself. It confirms the negative symptoms. Sometimes it confirms that I’m doing okay. Sometimes it confirms ‘maybes’. Sometimes I just don’t want to know!

A few colleagues have said to me at different times: “so what antidepressant did you choose?”

I guess it’s a tendency of health professionals to semi-diagnose themselves, think out a probably treatment plan and consider the pros and cons before going to another health professional, usually a doctor.

But that’s just not how it has been for me. I got sick. I felt awful. I got desperate.

So desperate that I just wanted to put myself in someone else’s hands, to not have to take care of myself anymore, to give the responsibility over to someone else.

I didn’t want to think about treatments, I didn’t want to know about the decision making process, I didn’t want to have the burden of deciding which antidepressant was most appropriate for me, a 26 year female of child bearing age with irritable bowel syndrome, reflux, previous clotting disorder and high blood pressure while taking an SNRI, venlafaxine, exercise-induced asthma, previous failure of therapy while taking an SSRI, fluoxetine, feeling suicidal despite taking 2 antidepressants for the prior 2 months.

I didn’t want the knowledge. I didn’t want the automatic analysis that I’m trained to give to any clinical scenario. I didn’t want to have to think it all out. I just wanted someone else to figure it all out and fix me.

So my message: think before you ask for knowledge, before you demand a translation from your doctor. Do you want the knowledge? Will you be able to handle it? How will it affect you? Do you really need it?

Or is it better to sit back, trust the doctor, and believe in the treatment that they have tailored specifically for your personal characteristics?

I’m not suggesting blind faith, or unearned trust but my recommendation is to think about what you ask of the doctor. Because they do have to give you the answer, even if it will only harm.

Because some words you can’t un-hear or un-read. Like when a doctor writes an insurance report for your income protection payout and gives it to you unsealed because you understand this stuff. And you read it and the reason he’s written for you not being able to return to work is that you are:

“totally incapacitated”.

That will hit you like a brick! It will make you re-evaluate your progress and current state of sickness/wellness. It will get you wondering if you are actually worse than you thought. It will get you wondering if you are useless.

It will start a chain of self-doubt and pondering. Suddenly you’ll think “can I” instead of “I can” or “I will”.

Am I actually a capable person who lives and breathes and cooks and cleans and drives and makes decisions and has responsibility?

Or is that a delusion? Am I actually not doing anything at all?

KNOWLEDGE IS POWER.

But can you manage the power or will it overwhelm you?

BE CAREFUL WHAT YOU WISH FOR.

Are you wanting to know details that can have no advantage or benefit to you, and are best left well alone to someone else’s responsibility?

Take it from me, if you will: you may save yourself a load of stress and anxiety, sleepless nights, fretting and worrying by leaving be details that will only weigh you down.

Let alone and be free.

wooden boat on an Amazon tributary at sunset

Peaceful serenity at sunset in the Amazon Rainforest near Puerto Maldonado, Peru