caerula's Diaryland Diary ----------------------------------------------------------------------------------------- hope Our story so far: I am hospitalized in a psych ward for med review and generalized anxiety disorder. I am there five days. I feel somewhat better when I leave, am off work for a week or so and start feeling a lot better. I go back to work, and then things start to fall apart in my marriage. Not for the first time, but this is the worst it has been. I begin to come to grips with the idea that if things don't change, I will leave my husband for the sake of my own mental and physical health. Then I begin to realize that this time I am so determined because of my time in the hospital, a major turning point for me. The amazing staff, the fellow patients, all of it finally came together to make me realize the truth of how much I needed to take care of myself, and how codependent Blue and I had become on each other. When I got home, it was the first time I was able to articulate how much I wanted things to change � how much they needed to. I also begin to realize that this time, I can recognize some of his behavior, relating to some of the other patients that were in the hospital when I was. The anger, the lashing out, the refusal to accept responsibility. These people weren't called immature or stupid; they had a disease, often a form of depression or bipolarity. Blue resisted this thinking, I suppose, because he had become comfortable taking care of me, and he knew how to do that even when he wasn't taking care of himself. He liked to tell me not to worry about anything, and didn't like it when I began to say that this was not how things were going to stay, that he needed to see a doctor, find someone to talk to. I don't know what convinced him, but I do think this weekend, when he was as depressed as I have ever seen him, something clicked. Most likely, I didn't pick the best time to tell him that if things didn't change, if I didn't see some effort that he was trying do something about his behavioral problems, then I would leave, and this time I wouldn't come back. He wanted to feel better, he finally told me, but he didn't know how. Here, finally was something I could help him with, now that I was myself finally working things out. So, interestingly, it now turns out that my husband really does have a good excuse for some of the immature and infuriating behavior over the last several months. Heck, over the good part of his lifetime. But, let me begin at the beginning (a very good place to start). The beginning being yesterday morning, not the the very very beginning up there. I know I wrote on Monday (another Monday Mission lost in the stratosphere, oh well) that we had been to the doctor, who was sending Blue to see a psychiatrist. The doctor's office said they would call us with the info when they had it. Yesterday morning, one of the helpful office people from the GP's office � which employees several of the unhelpful kind too � called for Blue before I'd even left for work. So he talks to her, then gets off the phone and tells me that (of course) hateful insurance company has to talk to Blue and approve it before he can see anyone. Because of course, Hateful Insurance Company (HIC) (and many others, I believe) treat psychiatric disorders differently from other health issues, because, you know, if something is wrong with your brain instead of, say, your heart or your liver, your insurance should definitely not have to pay as much out or make it just as easy for you to get treatment. So Blue calls HIC, which has a separate number for "mental health and substance abuse" then it does for provider authorizations. I love that too, that mental health and substance abuse are always lumped together, like one necessarily goes with the other. One may often cause the other, but not necessarily. Anyway, that's another rant. Blue calls the number and tells the case worker what the doctor told him, that he needs to see a neuropsychiatrist. I was in the bathroom finishing getting ready for work, so I don't hear the conversation, but suddenly Blue calls my name, and he is not sounding happy. I go out to find him standing there with the phone in his hand, look just so frustrated that I knew what was coming. "Could you please talk to this woman? She isn't making any sense. I just want to get in with a fucking doctor." I take the phone and explain to the woman who I am, and of course have to give it back to Blue so he can give verbal approval for her to talk to me. I still have half an hour before work, so I figure I'll sort it out and go in a little late; I tell Blue to take the med the doctor prescribed the day before, an anti-anxiety drug to help Blue over the humps until he gets into to see the psychiatrist, and then I talk to the HIC woman, who was surprising pleasant at first considering how horrid my husband had probably been to her, but then her true HIC nature began to show. What she needs to know is if the doctor wants Blue to see this neuropsychiatries (damn, I am tired of typing that. NP) for a health issue or a mental health issue. Again, the fact that they make such an issue of it annoys me, but again, not the place to go into it. So I look at the note the doctor wrote for Mark, and it says "testing/rule out bipolar" as far as I can make out. The HIC woman decides this is a mental health issue, and therefore HIC has to give us the referral, not the doctor's office. Figures. So I tell them that the doctor had told us, the day before, that there was an NP office at the University hospital which took HIC insurance. No, I am told, we don't have anyone participating at UM.
All right, fine. Can you give me the name of any other NP-type person in the area who does accept your insurance? Then I call Blue's GP. Talk to same friendly office lady, who says that oh dear, they must not have updated their book this year, as they still have university doctors listed as taking HIC. Says to call these two doctors and see what they say, and if I can't get anywhere, call GP back and he will call around trying to get Blue an appointment fairly soon. I figure even if we have to pay up front, I'm still having the pre-tax health reimbursement money taken out of my paycheck even though it will obviously not be used for IVF this year, so we will at least get it back in pretax dollars. So anyway I call the first name on the list (well, 2 names isn't really a list, I guess), and lo-and-behold, they just got in a cancellation for 11:15. Today (well, yesterday now, but you know what I mean. Yay! I say, we'll take it. I explain what the doctor has said, and they ask if I can call them back one more time and ask them to fax Blue's records, which they do, and even before we'd gotten there. By this time, it is 9:30, and I should have been at work before nine. Blue is in a sleep that resembles a coma, due to the meds; I know I will have to drive him to the doctor. So I end up calling off again. Grr. Boss unhappy. She happened to be in yesterday showing around New Boss Lady, so I ended up talking to her (Grandma Boss, not New Boss). Blah. So, I figure it will take us about 45 minutes to get to this doctor's office, being on the other side of Ann Arbor and seeing as how yesterday was the first day of Art Fair, which disrupts the entire downtown area, meaning as how I will have to take the expressway all the way around AA and get off on the other side and then find the doctor, presumably without Blue's navigational skills due to his coma-like sleep. I nap a bit on the couch. I start trying to wake Blue up around 10. Finally, by 10:30, he is actually out of bed, but doesn't grasp anything I am telling him, about the doctor's appointment or anything. Apparently this med makes him extremely fuzzy. If we had known that he'd have get up in two hours, of course he wouldn't have taken it, but who could have foreseen actually getting a doctor's appointment the same day? So I literally push him into his clothes, give him a Coke, and steer him to the car. We have, according to my not-so-careful calculations, exactly enough time to get to the doctor. Blue is zonked again by the time we turn out of our subdivision. Nevertheless, I got us there and in one piece and exactly on time, although not at all early as I'd hoped � there's always all that stupid paperwork. Blue was a little bit awake by this time and kind of annoyed at me, but I told him that if we'd had to wait until the end of August there was a good chance I would have filed for divorce by then (only half kidding). So we go into the drs office, Blue giving a good impression of a drunk, and I have to fish out his license and insurance card and fill out most of the paperwork, telling Blue where to sign, making sure he doesn't go back to sleep. 20 or so minutes later, when Blue gets called back, he groggily gets up and asks the doctor if I can come back with him � I'm rather glad, since I was rather doubting his ability to answer all the questions and stuff coherently. Which does, of course, turn out to be the case. Here is this doctor trying to determine if Blue could be bipolar, but when he tries to answer questions, he only sounds like someone just woke him up and all he wants to do is go back to sleep. He had such long pauses before answering, sometimes, that I thought he'd fallen back asleep and wanted to reach over and shake him. The benefit of this, I think, is that he answered the questions � and there were a lot � more openly than he might have otherwise, if he'd really been able to think about it. Occasionally the doctor would turn to me and ask what my opinion was of what Blue had just said, or if had anything to add; I did a couple of times, since Blue doesn't see some of his behavior as depressive or unreasonable. Blue filled out more paperwork, the doctor asked him more questions. In the end, the doctor decided to treat him for the time being as having a bipolar disorder. He has different medication now than the one that made him so zombie-like, and will be seeing the doctor again in two weeks for further testing. And the doctor is going to find us a counselor there, one we can go to together, since both of our counselors seem to have reached the conclusion that at this point we will benefit more from couples therapy. Which I agree with, and I think Blue does too, although he's still not big on the whole idea of talk therapy at all. Which is probably why he feels better when I'm there. So, going back to the beginning, which you've probably all forgotten by now, the thing is, basically, that Blue has probably been bipolar for years, back into childhood, with good spells and really bad spells. And so he has been labeled, from school on, an underachiever, not working up to his potential, lazy, no concept of time, out of control, angry, and, more lately, ADHD, depressed, OCD, even suicidal. He's never been properly diagnosed, and therefore has never learned the behavior management skills he needs to deal with overflows of emotion, whether good or bad. While it may not seem unreasonable to him to come home from work at 7 in the morning, vacuum the entire house, do four loads of laundry, futz around on the computer, clean YMB's room, and then go to bed around noon, only to get back up at 4 or 5, when looked at objectively that can be seen as manic behavior. Not manic like some people get, where they are being completely irresponsible and childlike, but all the same unreasonable. And when your wife is talking to you about the future of your marriage and you get in bed and hide under the covers, again, not reasonable, and fairly depressive, behavior. Mostly because the depressive incidents have become so severe, and so long-lasting, I think it has finally become obvious, to those around us if not yet to Blue. So it is all beginning to make sense. There will be much behavioral therapy, medicinal experimentation, and grief ahead, I am sure. But I think � I hope � we will come out on top, and Blue will begin to feel better, and, slowly, to begin to be able to do the things that were nearly impossible for him before � finish college, set a course in life, truly be a father to his son. We think. We hope. 3:33 p.m. - July 18, 2002 ----------------------------------------------------------------------------------------- |
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