Thursday, February 24, 2011

Back to the point, part 2

In my last post I started detailing the issues I've had during pregnancy with getting mental health care, which is the whole reason I started this blog in the first place.  I will continue the story with this post.

In late October/early November, I went to my general practitioner because my mood had started getting really bad since going off my meds (Seroquel and Lamictal) in August.  After talking to me, -- which involved a lot of crying on my part-- looking at my medical history, and looking at the cuts I had made on my arms, he put me back on a low dose of Seroquel.  For about a week, I felt not great, but functional, but then things continued back on their downhill spiral.  I was crying all the time, just wanting to sleep, having anxiety attacks, and doing a lot of cutting.  I called my GP back and talked to a nurse, who in turn talked to the doctor, who increased my Seroquel dosage. 

The increase in Seroquel didn't seem to make much difference, other than to make me more tired (something not particularly desirable when you're trying to chase a four-year-old and a two-year-old).  I called my ob/gyn's office to see if she could help out at all.  She put me on Vistaril as needed, which is pretty much just an antihistamine but can kind of mellow you out at the same time. Both my ob/gyn and my GP suggested strongly that I see a psychiatrist, but not wanting to go back to my prior psychiatrist, and with nobody recommending a new one, I was sort of at a loss for who to see.  If you've ever tried to get psychiatric help in Dayton, Ohio, you understand what I'm talking about.  There aren't too many psychiatrists, and those that there are often have a 3-6 month waiting list just to schedule an initial appointment.

In early December, after a few more weeks of generally decreasing mood and functionality, I called my family doctor again and the nurse recommended I go to Kettering Behavioral Health Center, a facility located in Centerville (I think) that has both inpatient and outpatient care.  They also offer walk-in assessments.  I drove myself over there and talked to the admitting nurse for about a half hour.  I explained I was about 21 weeks pregnant (in case she couldn't tell), was cutting myself daily, crying all the time, and generally feeling like utter crap.  I was worried that my mood was hurting the baby, and I needed psychiatric help to look over and manage my medications. She asked the $64,000 question:  "Are you suicidal?  Do you have specific plans?"  I told her that I frequently thought about suicide, but didn't have a specific plan to follow.  I thought about taking pills or slitting my wrists, but hadn't written a suicide note or anything.

At this point she assured me that the facility had an ethical responsibility to help me out, since I was a danger to myself and my baby, based on my suicidal thoughts and cutting behavior.  They wouldn't just send me home and tell me good luck.  She asked me to step out while she called the psychiatrist on duty and talked to him about what to do next.  My sense of relief was tangible -- finally, someone was going to help me.

She came out to the waiting room a few minutes later and told me that the psychiatrist wanted to admit me to try to regulate my medications.  I didn't particularly want to be admitted -- it was close to Christmas, and I wanted to be home.  But, I knew I needed help, so I agreed.  She went back to her office to talk to the admissions people to get the process started.

About 15 minutes later, she called me back in to her office.  As it turns out, they couldn't admit me to their facility, because I was more than 20 weeks pregnant, and they didn't have the medical facilities to help me in out in case of a problem (they are not on the same grounds as the actual hospital).  What they could do is prescribe Klonopin for me, a powerful anti-anxiety drug, increase my Seroquel again, and suggest if I was still having problems to either call my old psychiatrist or go to Miami Valley Hospital's ER.

And with that, despite their "ethical obligations," they sent me on my way.

Next post:  a new psychiatrist and the ER.

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