PLEASE Help me to understand
 

Friends, it's been awhile since I've given you a status update on how my DH is doing. I will tell you, but I have to say, I am a bit confused about his current condition. A brief overview is this: He gradually became manic, with paranoid ideations around the first week in June, and that's when we brought him to the Crisis Center. He stayed at this Psych Facility, I'll call "HH", for nearly two months, and his meds were all changed around; he was taken off of all his previous meds and put on all new psych meds, like Depakote, Risperdal, Trazadone at night, and a anti-anxiety PRN. Once they had him on what they thought was an optimal dose, he was maintained on those doses for the length of his stay. By the end of his stay there, I actually thought he might have been well enough to come home (but my son and his wife were skeptical, so when they wanted to transfer him, I really had no choice but to go along with it).

To complicate matters further, this place did not want to release him to home, even towards the end of his stay, once his mania was controlled and he started acting more like himself. The reason for that was because when he was there back in 2003, he stayed there for six days, fooled them into thinking he was no longer suicidal (remember he has a masters degree in clinical psych, so he knew all the right things to say), and, within two hours after arriving home, he had a very bloody, messy suicide attempt. From there, he was treated in other facilities, was given ECT treatments, which vastly improved his depression, and then recovered. I firmly believe that this was the only reason they wanted to send him to a 'county facility' instead of home.

Sorry this is so long, I'll try to wrap it up here...Last part of the story... he was transferred to this other hospital, where they basically left his meds the way they were. I wanted to know what they planned to do, and had his pdoc call me. Unbelieveably, the first thing this doctor said to me was that he was unclear as to why my DH was even sent to this new facility!! :eek:...At this point, I explained my theory, and he really just listened but seemed to understand the 'logic' behind it all. My main reason to speak with him was because I was concerned because my DH seemed very sluggish, flat and confused when I saw him the night before. To which the pdoc thought he might be over-medicated (duh) and planned to cut back on his Depakote, and increase his antidepressant. He said I would probably see a difference by this week-end. However, last night he was SO VERY QUIET, had very little to say, and just sat there, looking either dazed or tired (when asked he said he was tired).

I hope I've explained the situation, such as it is. Now the good news: They had a meeting and told him he was going to be D/C on Friday, Sept 9th!! He seemed to be happy about the news, but I'm still concerned about his demeanor. He has said to me that he doesn't like it there, which could explain his down mood. So far, I haven't gotten anymore out of him than the fact that he wish he could get out NOW, not on Friday.

Can anyone help me to shed some light on his current behavior? If it were you in his place, what would you be feeling now? Any insights or suggestions? I'm just perplexed as to his current state, could it have to do with the med reduction? I don't exactly know what the pdoc did with the meds.

Any and all points of view or suggestions WELCOMED

Thanks in advance!

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** I was so unsure about even writing this long post that I almost deleted the whole thing, so I apologize in advance if this thread is in any way inappropriate. **

HI Jacquie

glad for the good news... BUT... i don't see how they can discharge him if he is still in the state you describe. ASSUMING he becomes more ehhh "talkative" ... lively, etc...

theory #1
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i recall when you transferred him, and went to visit, they stripped you of your keys etc when going in. this to me suggests they run a pretty tight ship, and might have a lot of constraints on the patients.

one of the things that bugged me when i was inpatient was:
-- the way the windows i can't remember exactly if they couldn't be opened, or only just a crack maybe.
-- room doors could not be locked
-- personnel came to check on you 2-3 times at night... i had a hard time sleeping and woke up every time. one nurse used to let the door slam. i asked her if she would mind closing it quietly and she blew me off, and from then on referred to me indirectly with an insulting name made in gestures.

i was amazed we had mirrors in the bathrooms in the private rooms. maybe he doesn't. one patient had a vase and it was confiscated. shoelaces are frequently confiscated as is basically anything that someone could use to hurt themselves or someone else, even if it isn't a suicide watch ward.

it might be as simple as a clash with personnel, or other patients bugging him, or freaking him out a bit. there really could be a lot of things in their environment that are genuinely unpleasant to have to be in day and night.

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theory #2
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it could also have to do with the med reduction depending WHICH med was reduced - it could be a pre-paranoid state. i would ask the doctor which meds were reduced. i would not report immediately to the doc that hubby doesn't like it there. however, i would DEFINITELY try to get hubby to confide in you what is bothering him, and go from there.

if they are reasonable things, such as limitations on freedom or being bothered by personnel or patients... ok. if they sound unreasonable to you, like he thinks someone is following him around, or that he is being spied on by personnel, or any bizarre ideas, etc... you'll need to tell the doc - maybe not the details or he won't trust you again, but you should somehow communicate a concern in seeing a change for the worse, with possible delusional aspects, and ask for a reevaluation before d/c.

if he communicates depressive type thoughts in general, esp. with suicidal ideation, you should inform the docs explicitly.

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theory #3
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could they have screwed up the med doses in the transfer.... if so he might still be overmedicated..... this place does not sound great if the doc did not notice your hubby was a vegetable and geez... could be overmedicated before your report from your visit!!!! :eek::eek:

~ waves ~

Oh, Jacquie, this was supposed to be such a happy event! I'm sorry there's a qualifier about it. But maybe, for the family, there often is.

Only 2 things occur to me: meds that are just off, or someone annoying. I'm basing that solely on my experience in hospital. I'm guessing you'll know whether the latter applies. The meds might be more difficult--do you know exactly what he's taking & in what quantities?

Do you make contingicy plans when you bring him home? Like someone always being awake for the first couple days?

You know you'll all be on our minds & in our hearts when he is home:In-Lurve::grouphug::heartthrob:.

Thank you so much, waves, for your detailed possibilities concerning my DH's behavior. I don't have time to get into a further discussion right now, as I have to get ready to begin the trek to visit him right now (I should probably already be gone!).

Thank you also, BCG, for your thoughts.

I will let you all know how it goes with DH tonight.

Good Luck Jacquie!!!

np... i actually felt a bit bad - longwinded and drawn out as usual and possibly inappropriate... remember i am not there... use your best judgement, go with your gut and all that...

i hope everything works out alright!!!

(((hugs)))

~ waves ~

I love your posts waves they are usually right spot on!
((((HUGS)))))
bizi

Hi Just Jacquie
 

What is the root fear that he has? The medicines should help,followed by love, and reassurence of the things that he fears,probably irrational things,will not happen. This type of thing is very complicated,and time,medication,and patience should help the situation.

Did his symptoms just come out of no where,or did he suffer a bad experience when he was growing up,or a young adult? Do they come,and go over the years,and keep coming back? BF:hug::hug::hug:

Personally I think Waves hit it on the nose.

And I think you will figure it out.

Donna:grouphug:

Waves did hit the subject on the nose didn't she. BF:hug::hug::hug:

Dear Donna,

I hope that he is doing better.

It is hard to sleep in those places. . . . . lots of noise on the floor, interruptions on the floor during the night, . . . . . most places have mandatory wake up / get out of bed times. He was on what seemed like a massive amount of depakote you mentioned in one of your posts.
Are they going to send him to an out patient day program when he gets out?

waves, before I left to visit DH, I re-read your various theories over; I had no idea what I would face when I got to see him again this evening. Happily, I could tell he was better as soon as I saw him. His face looked 'brighter', he actually had a smile on his face. When asked how he felt, he said he felt much better than he did last night. I can only assume that the reduction in his meds is finally paying off in a more alert, closer-to-normal acting hubby! To his credit, when I spoke with the pdoc the other day, he said that I would probably notice a difference in him by the week-end, so I have to believe that his condition will continue to improve. I specifically asked DH what was going on last night and why he was so quiet and 'out of it' during my visit, and he really couldn't tell me. I asked if he was worried about something, or if something had happened, and he had no answer for me. I specifically asked him if he felt at all suicidal, and he quickly said no, not in the least. We counted down the number of days he had left there, and was happy to realize that he will be out of there in six days! Tomorrow night will be another test, as my son will finally be able to go with me to visit, and I just hope my husband reacts well, and is better even than today. I think that my son is still doubtful that his dad is ready to leave the hospital.

waves, I a feeling that this place does not respect the patients privacy and rights. Tonight, he told me that this morning, a woman went into his room and took his slippers that I just bought it a few weeks ago. He didn't even know who the person was, but was afraid to say anything - I think he was afraid of what she would do. I spoke to one of the aides as I was leaving, and she said she saw the woman wearing the slippers, and she would get them back.

BF, you kind of came into the middle of our whole story about our sad history. I will briefly tell you that my DH has been Dxed as bipolar way back in 1984, and has taken meds ever since, and been successful at work with the State of NJ for 32 years. He had one bad depression in 2003, when he actually attempted suicide. He recovered well and went back to work. Then this past January, we had a fire in our house, a raging one, and it took the whole house and apparently took over 90 minutes to get it under control. My DH and I were trapped in a downstairs bedroom; i stayed put, but, early on, he had gone out of the room to see if there was any way to rouse and help rescue my daughter, but it was not to be, ando. he burned his hands in the attempt He had gotten third degree burns on both So, you see, both of us suffered PTSD at the loss of our home and our and, in addition, the loss of our 27 yr old daughter, who was asleep upstairs in her room He then spent two full months hospitalized in the Burn Unit at Temple Hospital. That type of tragedy is what caused his PTSD, and mine as well.

Thanks again, all! I will keep you informed of how things go as the days progress.

such a sad story for you and your family.
am happy that your hubby was better...I like the idea of an out patient therapy...where he goes for therapy during the day ( 8 hours or so)then comes home at night to stay with you. This is often very good transition...ask about this.
bizi

Dear Jacquie

that is great news!!! :)

it's possible when your hubby was numbed out he had other intruders and clearly this would bother him, but might not have been able to rememeber specific event(s) while doped up - only a lingering sensation of discomfort. Depakote affects cognition and memory.

i too like the idea of outpatient therapy. daily even if not for 8 hours. i don't know what is available.

Hope the visit with your son goes well.

Keeping you all in my thoughts. :circlelove:

~ waves ~

I am so sorry. I didn't know. BF:hug::hug::grouphug::hug::hug:

Dear Jacquie,
. . . . such good news! The reduction in meds seems to be helping. Keep up your strength and your hopes.

M

You have no idea what a help you all have been to me
 

I am so very grateful for all of the insights you all have shared with me. I may KNOW bipolar, but I do not THINK bipolar :o, so your input means so much. Ironically, the previous hospital had spoken about a partial day care program, but this place has not mentioned it at all. On Tuesday morning, I plan to be on the phone early with his pdoc, and Princeton House, where he had gone back in 2003. My daughter had gone there, too. He did very well at that program, but, at that time, he was an inpatient at Princeton House, which probably made it easier to transition to the Day Program. Maybe his pdoc could assist in that.

I did try to get more info out of DH at last night's visit, how he is feeling psychologically. He made it perfectly clear that he was in no way suicidal. He also told me something that I believe has been in the back of his mind since the fire. He said that, in a dream, he saw Andrea standing up in Heaven, and she forgave him for not being there, standing next to her. That goes back to 2003, when he attempted suicide and she was the only one home, and she essentially saved his life by doing all the right things, despite her horror and fear. My DH, in the back of his mind, feels guilty that he could not return the favor by saving her from the fire, even though it was a totally different situation and impossible. Hopefully, he will now be able to move on, knowing that there was nothing either one of us could have done and she was probably already unconscious or worse by the time we were rescued. The dense smoke went right up the stairs, there was no door to stop it, as was the case with our bedroom. We had the door closed.

Anyway, I am hopeful that tonight's visit with my son will go well. Due to a recent illness, hurricane Irene, and his crazy work schedule, my son has not been able to see his dad since he was transferred to this new hospital.

Today is a beautiful day, Labor Day Week-end, and we plan to BBQ a chicken under a brick, a la Emeril. I wish DH were here with us now, but we are counting down the days!

Enjoy the rest of the week-end, everyone !!

Jacques

I think the doctor, and the others probably hit it on the nose.

the depakote was way to much and was over medicating him.

I'm personally so glad the new pdoc saw this and reduced him.

I also think this is why he kept him in the hospital to be watched
for a week.


I think you should also count down the days here.

We can always use the celebration too.

Donna:grouphug:

good luck in the days ahead of you.
keep posting here if it helps you.
((((HUGS))))
bizi

Dear Jacquie,
Enjoy your BBQ :)
I hope that everything continues to get better for your husband.

M

Dear Jacquie,

thanks for the update... things sound very positive.
here's wishing all of you the best and hoping hubby continues to do well.

Happy Labor Day and enjoy the BBQ with the rest of your family.

(((hugs)))

~ waves ~

We had our visit last night, and my son finally was able come with me. I was a bit worried that DH would say something that sounded crazy to my son which would cause him to question his readiness for D/C. I was thrilled with how the visit went, and my son felt more at ease about his D/C :p ! So we are continuing the countdown to Friday.

Only four full days to go !! :D

that is super Jacquie! :)