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?