Archive for March 29th, 2009

Day 1437 to 1443. Monday 23rd to Sunday 29th March 2009

Oh god, horrendous week this week, Karen completely rock bottom and nearly losing the plot :-(

Last Sunday night, I did a full Roast and trimmings (lamb I think), but by the time it was all done, kp wasn’t feeling like any food at all. Part of her not liking to eat is that she gets overfaced by a normal portion size, so I did a special small portion size for her to try and tempt her.

tempting3

But, even this couldn’t tempt her :-(

Monday saw Rachel (the OT) come and they discussed getting Karen some swimming lessons. Sounds like Rachel knows an OT who is also a swimming instructor and could give her private swimming lessons. They also discussed a quiet venue. kp was as flat as a pancake and the meeting was quite awkward. We had ordered some Pilates videos for kp, and once Rachel had left Nat tried to keep kp occupied by watching these with her, but she remained unusually quiet.

Tuesday and Natalie was on a first aid course all day, but it didn’t matter, ‘cos we were going to the psychiatrists in the afternoon anyway for an appointment that Jane (the psychologist) had made the previous week. We were so glad he could see her. The trouble with appointments like the psychologist and the psychiatrist is that our expectations are so high. We go in wanting magic bullets, but that’s not always what we get, probably ‘cos they don’t exist. Here is kp waiting to go in….

pscyhe2

The upshot of the psychiatrist meeting is that he thinks the mood improved when she started taking amytrypteline and so he has up’ped this to 150mg a day (instead of 100mg). Neither kp nor I felt like this had hit the nail 100% on the head. There was a niggle inside both of us that said he was a little wide of the mark. But, kp was active in the consultation and asked lots of questions and we left feeling “ok” and that the recommended action was worth a go. We convinced ourselves that he knows what he’s doing (and he does), and that he’s probably right. He’s done the job before for kp, which he has etc etc….

Certainly, the sleep improved, with Karen getting a really good sleep, and weirdly her appetite has been better with kp eating at least 3 full meals during the course of the week, which is pretty much unheard of these days.

Wednesday, Nat was back. kp had a scheduled hairdoo and was getting her nails done. Nat took her, and all seemed fine.

But, then after Nat went, things took a major turn for the worse :-(

We were sitting in our respective seats in the living room, when kp just burst into tears. We can’t remember why, but there was no discernible reason. I went over to comfort her and things got worse over the next 30 minutes or so. She was out of control, screaming and the best way to describe it was “losing the plot” (although this is a little strong). I tried reason and discussion, but it didn’t help, so we needed distraction. I suggested a hot bath, which she agreed to. She knew she needed distracting too. So, into the hot bath, but this pretty much just transferred the problem to the bath, and she was struggling holding back the sobbing and “out of control’ness”. I felt absolutely awful, powerless to help her. I knew distraction was needed. It was too late to call anyone. Karen was afraid that if we called the emergency services, she would end up in a mental hospital.

kp(sobbing):- I’m not going in a mental hospital, ….(sobbing)…., no way……(sobbing)……..

I have an awful memory, but I vaguely recall similar behaviour from around the time Karen realised that we were never going to be able to have kids, and that we had decided against adoption. The end result that time was a mental breakdown. I felt that another one was imminent.

I was in crisis mode. I was talking to her constantly, and now I am writing this, I can’t recall at all what I said specifically, but I do remember saying lots of little things to try and help her regain control. I do remember how I felt – It was as if Karen was a big tanker in the sea about to crash into the pier, and I was a lone tugboat trying desperately to pull her clear of the pier. That’s exactly how I felt – like there’s no way I can save her, but I wasn’t giving up, and all my little verbal nudges and tugs (pardon the pun) evertually diverted her from the crash. It’s Sunday when I write this, and I still can’t believe we made it through that night. I felt sure she was going to have a mental breakdown. And we don’t want to go there again. Having said that, we were discussing this later in the week, trying to recall what happened when she had the mental breakdown after the IVF, and we both seemed to remember that it was the last step to acceptance for Karen that kids weren’t destined for us, and life got better after that. That said, we definitely DO NOT want kp to go there again. That was a horrid time !

So, by some miracle, disaster was averted, and we made it through the screaming and dispair. It was a late night, that night, and we went to bed, with Karen having STRICT instructions that if she woke in the night (as she does), that she MUST wake me up. I definitely didn’t want her to go through this alone.

The following morning, I was straight onto all our specialists (Case Manager, Psychologist and Psychiatrist). I won’t go into all the calls in detail, but suffice to say that we got somewhere. Coincidentally, the psychologist and psychiatrist had been talking about Karen the day before to see if they could “hypothesize” what had caused Karen’s drop in mood. They were both in agreement. It wasn’t a psychological issue, there was nothing that had gone wrong in kp’s life and no reason for kp to feel so so bad, but something HAD changed from a psychiatric point of view. DRUGS !! Karen had been withdrawing VERY gradually from Gabapentin. And she had come off it completely a couple of weeks ago. She was using the Gabapentin for nerve pain, but one of the other ways Gabapentin works is as a “mood stablizer” and it is sometimes prescribed for this reason. It is one of the drugs that crosses the blood-brain barrier, and apparently, it can help other drugs that cross the blood-brain barrier have a better affect ie Venlafaxine (her anti-depressant). So, we had an explanation for her drop in mood. What was the solution ?

Well, Karen had a choice to make.

  • Cold Turkey, sit it out and wait for the symptoms to go
  • Go back on the Gabapentin (but it would take 2 weeks to kick in anyway)

So, kp made the “Cold Turkey” choice, but I asked the psychiatrist what should she do if she has another attack like last night. THANKFULLY, he had an answer in the form of Diazepam (Valium). He told us to go to the doctors and get some Diazepam and take one if these symptoms recur. Two hours later, we had made the visit and had Diazepam to hand. Now, came the hard bit. We had worked out that she had been off the Gabapentin for 10 days when the incident occurred, and it can take 3 to 4 weeks to be clear of the symptoms. That meant another 11 to 18 days of possible nights like Wednesday night. Karen is going for it. And we had an emergency button that would calm Karen down if she had another bad night in the form of Diazepam. We felt marginally better about it, but we’re both anxious if she could make it. It was the best we were going to get.

Day at a time !

So, it’s now Thursday, hectic day with calls to the specialists, doctor’s visits and she was due to go with Nat to physio in the afternoon. We had took a decision early in the day, that this wasn’t a day for physio or for being with Nat, excellent though she is. This was a “day with hubby” day. My aim was to keep her busy and entertained/occupied. We cancelled the physio and it was a nice but windy day, so we decided to take the dogs for an extra walk to a place we used to go when the dogs were much younger. It was just what Karen needed. It brought back lots of nice memories, and the wind was howling and totally took kp’s mind off things. It was freezing too, but we didn’t mind. The dogs loved it.

Once back from that, we started watching the american celebrity version of apprentice, which was a great distraction. We probably snoozed too, but basically we kept her busy and we got through an upset and despair-free thursday.

Friday, Nat was back and the objective was “keep occupied”. Nat arrived and the girls went straight off to the gym. Physical exercise is very good for depression, and I think it did help. No tears Friday :-) Go Karen go ! All looking good so far ! No Diazepam consumed, which is great, ‘cos it’s addictive (if used for >4 weeks) and we only wanted to use it as an emergency. Abbie and Louisa were due to stay friday night, and kp was due to go to Middlesbrough for a Sisters Day, but both of these events were cancelled.

Friday night saw kp have a whopping 13 hour sleep (split into two). The sleep took kp to about 3pm Saturday. We kept her active in the afternoon. Saturday night = pizza night, our favourite night of the week and things went tits up again. Not as drastic as Wednesday night, not even close, but still upsetting. Lots of tears (for no reason), and signs of her losing control if we didn’t act. I wasn’t keen at suggesting Diazepam, but there was a point in the night where I was left in no doubt that it was the right way forward. And whether it worked or she just calmed down, we don’t know, but the upset subsided, and we went to bed.

Today has been ok so far. Steady away ! We were walking the dogs at 7.30am (6.30am body clock, ‘cos of the clock changes). And since then have watched TV, snoozed and the day is going “as well as can be expected”.

So, bloody awful week. The worst thing is not knowing if kp will make it through the next couple of weeks without another episode. But, at least we understand why this week happened and we have an emergency button for if it does. As usual, Karen has to be the one to go through it. She keeps apologising for it and thinks it’s her fault which does my head in. I keep trying to get across to her that it’s NOT her fault. We’re a team and we have to get through this together. I also keep telling her that we ARE going to get through this and do you know what, something in me tells me that I’m right, and that this could be Karen’s last big hurdle. It could be wishful thinking, but it’s a hunch based on past history. Time will tell……………..

We’re ready for turning a corner, that’s for sure.

New beginnings !

lambs

(Lambs from yesterday’s dog walk)







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