Ward Round #4

This week, there were only 3 Doctors there – no therapists, nurses, members of the community team, or students – so my consultant said it couldn’t really be called a ‘Ward Review’, but was going to see me regardless.

First of all, we talked about how my week has been. I told the consultant that upping the antipsychotics knocked me flat out on the first day, but I’ve been fine drowsy-wise since.
I told her how difficult I’d found it to wait around for my APIP appointment, which had kept getting postponed. I also expressed concern that the input may be decreasing, as word is that one of the nurses is being transferred. I told her that it was the most valuable thing I was getting out of my stay here, and that I would do it every day if I could.
I mentioned as well, that I had been referred to OT (Occupational Therapy – which is not about how to do your job, but more about how to live a fulfilling life) and never heard anything. She said she would chase it up.
She also mentioned that the ward’s activities coordinator is back today after her prolonged sickness, so those activities may be of some use to me.

We talked quite a bit about my social anxiety, and the incident at the chippy on Saturday. I also talked about my sensory issues, and how I was finding it difficult to cope when around people, but also difficult to be on my own, so it was kind of Catch 22.

She asked what I was afraid of, regarding people. I said that I don’t feel safe around strangers. I told her that I was worried someone might look at me, or talk to me, or touch me. She asked what would happen if someone touched me, and I told her the story about how at the beginning of my crisis a toddler had ran in to my legs at the GP office, and I had freaked out so much that I had to be taken out of the waiting room and get my boyfriend to come and walk me home.

I explained the events of the night before to her; that I was so sensorially heightened that I ended up in a dissociative state, and harming myself. She asked about the mayonnaise, and people touching things, and if any of these feelings could be related to the Coronavirus pandemic. I said that I don’t really think I’m that scared of it, but it’s definitely getting to me a bit, and I am taking extra germophobic precautions as a result.

She talked a bit more about my discharge plan, and wants to push forward for this referral to the ‘halfway house’.
I don’t know how useful I would find that tbh.
Atm, I need someone to be in charge of my medication (which I don’t think they would be there), and to be in an environment where I can’t hurt myself (which, again, I don’t think would be the case). I don’t need to be somewhere that is self-catered with assistance for meals, cleaning etc – I’ve got literally no issues with that. I just cannot be out in the community atm. I would like to think that when I’m well enough to keep myself safe, regardless of what life throws at me, I will be in a position to be able to go straight home. Hopefully my new home.
It panicked me a bit when she said she wanted to move forward with the referral, but my Dad says that these things generally take weeks.
I hope so.
I’m quite happy staying here in my room, for the most part.

I mentioned to her that I’ve developed a tremor, and that I don’t feel my PRN diazepam is working for me anymore. She said that sometimes you can build a tolerance to benzodiazepines, and that the best thing to do is to focus on adjusting my regular medication rather than my PRN (which is to be taken as and when required), but she wants to monitor my tremor.

She decided to up my quetiapine, which is an antipsychotic, from 25mg twice a day to 50mg twice a day.
I asked what the maximum dose was, just for context, and she said that if it is not being used to treat psychosis, but being used to stabilise mood and treat anxiety, it’s generally about 300mg, so 100mg is still quite low. I’m keen to keep on down that path – see where it takes me.

I’m going to stay on my mood stabilisers as well.
So that’s pretty much double mood stabilisers.
All the mood stabilisation for me!

Tl;dr
Upped my antipsychotics
Keeping on with my mood stabilisers
She’s going to chase my OT referral
Continuing with input from the psychologically trained nurses (APIP)
Continuing to plan ahead for my discharge, even though it’s still a fair way off

More progress.

2 thoughts on “Ward Round #4

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