So I’m back in hospital and have been since 17 December. It seems like everyone saw it coming; my mum, my aunt, my friends, the nurses, even readers of my blog. Everyone except me that is. Huh. Naively I thought if I didn’t have any physical health problems, they wouldn’t form me under the Mental Health Act, and I believed my case manager when she said they wanted to keep me out of hospital. This is a new low for me, one month out before being back in again. Usually I’m able to keep out for at least four months between admissions.
So how did it happen? It started with two of my friends whom were also inpatients last admission voicing their concerns to me. They were concerned I wasn’t eating much and I’d lost weight all over again, and had convinced themselves I was at risk of dropping dead overnight. They asked me to come to the Emergency Department with them, I told them there was no need and that I was fine. After much convincing and my friend saying that she wouldn’t sleep at night worrying about me, and that they couldn’t forgive themselves if they had to attend my funeral, I came with them into the psych triage at A St. I went out of guilt and I was sure whoever I saw would also agree that I’m fine. Spoke to a nurse and a doctor who were happy for me to go home and said they’d talk to L, my community mental health nurse/case manager. The next day I had a visit from my case manager who said that she’d talk to the psych registrar, Dr D, to see if I could get an appointment with her during the week. On Tuesday morning I then got a call from L asking me to come in for an appointment with Dr D that afternoon. I went and drove to my appointment without any inkling whatsoever that I wasn’t going to be able go back home that afternoon. I was told by Dr D they had spoken to the inpatient consultant psychiatrist and that they wanted me to come into hospital. If I didn’t agree, I would be formed under the Mental Health Act. My relatives had to pack my bag for me, come drop it off and drive my car home for me.
The next morning I was reviewed by the doctors and dietitian where I was told I’d be put under a Form 6 under the Mental Health Act, they’d be inserting a nasogastric tube, I’d be put on bed rest, be on a 1:1 nursing special, and whereas last admission they discharged me at a BMI of 16, this time they wanted me at a BMI of 18.5. “What if I eat and or/drink orally?” I asked, desperate to avoid an NG tube. They replied that it’s “Not negotiable.” Obviously I was upset at all I was told, and after the review I tried to abscond from the ward. Unfortunately it was my poorest effort yet, and I didn’t get very far before a nurse and a doctor caught up to me, grabbed me by the arms and forcibly escorted me to the seclusion room of the PICU/locked ward.
It’s there I stayed for six long days. I refused to let them put the NG tube in so I was restrained and injected with midazolam so that they could try and force it up through my nose. The events are a little blurry, but I remember a nurse trying twice to get it in, me trying my best to prevent that from happening, and somehow or other I actually got out of it and thus far no NG tube has been put in. A short time after that, my blood pressure apparently dropped quite low, and a code blue was called. I was pretty out of it by then, but remember having an oxygen mask and getting IV fluids put through.
For the first few days on the locked ward I was confined to my room on bed rest. I found that very hard to handle, with nothing to do except read a book or stare at the wall. Being a PICU, everything is taken off you- phone, iPad, electronic equipment, cords, toiletries, anything breakable, jewellery, bag, keys, wallet, and plates and cutlery were all plastic. I self harmed at one point by using my nails to scratch my arm and using my watch to hit my arm- until I was restrained by nurses and security guards on my bed, and had my watch taken off me.
On Monday when the dietitian and then doctors came to see me I was told I would be allowed to be wheeled in a wheelchair to the lounge room to watch TV- but still not allowed to have my meals in the dining room or participate in OT activities. Though those conditions were a tiny bit better, I was upset that I was still so restricted, and not allowed to even walk 5m to get from A to B. In addition to this, because aforementioned friend was also in the locked ward, staff wanted to prevent us from interacting and we were told we weren’t allowed to talk to each other. At one time when we were both in the lounge room, a nurse told me I had to go back to my room, as we were apparently communicating with each other. That’s when I got pissed off and started arguing- we had not said one word to each other that whole time in the lounge room and it felt so unfair that I was the one kicked out when there’s nothing else I can do. There was one night though where the nurses didn’t care that we were talking to each other, and it really helped my mood to be able to chat and have a laugh with her, other patients and nurses. On the locked ward I was so bored and depressed that I didn’t give a shit any more and actually ate, even extra food like ice cream, chocolate and cheese toasties.
I was moved back up to the open ward on Christmas Eve. After being in such a controlled and restricted environment, it is such a relief to be back on an open ward. It’s much more relaxed, I have all my belongings back, I’ve been having my meals in the dining room and have been to the OT groups of cooking and art. On Christmas Day I had a few hours leave with my relatives, as my parents are overseas at the moment. I was seriously contemplating killing myself if I was still in the locked ward and confined to my room, but as I wasn’t and had been moved to the open ward, I was in a good enough mood that I didn’t bring back to the ward things to harm or kill myself with. It was nice getting away from the hospital, being away from being constantly watched and getting to see my dog, even if I did eat then purge while home.
I’m still on constant 1:1 nursing, and this is the longest that I’ve continuously been specialled. The doctor on duty came to see me today, and it happened to be the doctor I was seeing whilst inpatient at another psych ward during October/November 2011. He remembered me, and joked “You’re always needy!” about me being specialled….again.
Unlike last time in hospital, this time I’ve actually been eating and mostly compliant. I’m trying not to think about it, how much I loathe being controlled, being made to gain weight, eat way more than I’m comfortable with and how fat and disgusting I feel. I’ve been told they want me to be 46kg before discharge but there’s no way I’ll be okay with that. I’ve never been 46kg in my life, the most I’ve ever been is about 43kg, and that’s when I was eating normally and hadn’t purged in months. I’m Asian, 158cm with a small body frame and 46kg is too high, none of my clothes will fit at that weight. Right now I don’t even plan to go home and lose weight all over again, I could probably live with maintaining at around 40kg which would be high enough so that I don’t get scheduled under the Mental Health Act, but I’d rather kill myself than be 46kg. If necessary, I believe I do have the means to do so properly. When I came into hospital I was 34.8kg, just 11 days later I was 39.0 kg this morning. I’ve been told they expect a gain of about 1kg a week, and in less than two weeks I’ve already gained 4.2kg. On one hand that gets me out faster. On the other hand it proves to me that this amount of food is way too much for me, I’m always bloated and I’m ballooning with how much I’m eating.