Part 3: At the hospital now

[stolencrumbs]

This is a continuation of a previous thread: https://bpdfamily.com/message_board/index.php?topic=337035.0

I talked to a nurse this morning. Her head is okay. It doesn’t seem to have reaggravated the head injury she struggled with for a few months. Her blood pressure was 70/50 in ambulance. Nurse said it is still low, but okay.

She’s now in the medical detox unit. I assume this is because they have stopped adderall. I’ve called the therapist I talked to yesterday, but have not heard back. I don’t think they’re refusing to speak with me, just making it difficult to do so. I don’t think they’re terrible. I think they they have too few resources and take a pretty generalized approach with patients. I’m visiting at 3:00 today and will push to talk with somebody.

I agree with ff and notwendy about being forthright. And yes, my wife absolutely wants us to be a team that keeps lots of secrets. I’m not doing that anymore. I’ve been talking with her parents every night. They have a bit better picture of what’s going on and has gone on. They are very supportive, and want to be here when she gets home.

I’m doing all right. Feeling guilt for sure. My wife’s voice is still in my head. I’m also realizing while being home just how much of my life was about trying to not make her mad. I find myself worrying about putting things in right place, or doing x or y with the dogs, or sitting on the wrong piece of furniture, or using the wrong coffee mug, etc. it’s nuts how ingrained that thought pattern is.

I asked my friend last night if he thought we seemed like a happy couple when we first met seven years ago. His answer was interesting. Initially he did. Then he got to know me individually, hanging out without my wife. Then when we were together, he says my voice literally changed. That I was not really the same person he had gotten to know. He’d never told me that before. My sister-in-law, who has known me since I was twelve, also said I sounded like the brother-in-law she used to know. Things to think about...

[Gemsforeyes]

Hi SC-

What other “head injury” did she struggle with for a few months?  Was that self-inflicted?

Are there any other options, like a group counseling home, for her to go into when she’s released from the psyche hospital, rather than right back to your home?  I just feel that puts way too much on you.  There has to be a way to express the danger of this situation.  But at least her parents will be there (hope that will help?)

I hope you’re okay.  I’m glad you’re at least able to spend some time with your friend and begin seeing how the marriage has truly affected you.  You can take this knowledge and put it toward healing yourself; and communicating that things canNOT return to the way they were.

Warmly,
Gemsforeyes

[formflier]

If the phone approach isn't working.  Ditch it.

Yes it may take more of your time, a lot more of your time but I think you need to head to hospital and stay for a while.  Make rounds.  Instead of calling you are waiting outside with receptionist.

If they are busy (which they likely are), ask for an appointment to speak on the phone or in person.

Push.

Anything you are "assuming" please clarify with them.

This may be "just the way" it works there.  I had a similar experience with my Father in long term care.  I took it personally until several people I trusted revealed similar experiences and gave consistent advice.  I assumed there would be a team that communicated with each other.  Sadly the answer is no.  So...I forced communication. 

Once it became easier and more pleasant for them to communicate with each other and coordinate care...they did that.  I had to be a A##hole for that to happen.  So be it.

Hang in there.

FF

[stolencrumbs]

Hi SC-

What other “head injury” did she struggle with for a few months?  Was that self-inflicted?

Are there any other options, like a group counseling home, for her to go into when she’s released from the psyche hospital, rather than right back to your home?  I just feel that puts way too much on you.  There has to be a way to express the danger of this situation.  But at least her parents will be there (hope that will help?)

I hope you’re okay.  I’m glad you’re at least able to spend some time with your friend and begin seeing how the marriage has truly affected you.  You can take this knowledge and put it toward healing yourself; and communicating that things canNOT return to the way they were.

Warmly,
Gemsforeyes

The injury itself was not self-inflicted. The fact that it took so long to heal was due to her. A heavy dish fell right between her eyes while she was trying to get something else off the shelf. She had multiple fractures and a spinal fluid leak, which caused lots of headaches, dizziness, nausea, etc. Bed rest is the treatment, and to not do anything that puts pressure or strain on her head. She screams and cries all of the time. She would feel better for a couple of days, and then have a meltdown, and her head would go right back to how it was. She would also hit herself in the head. She reopened the wound a couple of times, and would try to hit herself where she knew the fractures were.

There is an intensive outpatient program run through this hospital. My T was much more complimentary of the outpatient program than the inpatient, so I'm hoping for that. There are some group homes, but there is no chance she is going to voluntarily go there if she has the option to come home.

[empath]

SC, do you know if the therapist and doctors at the hospital are aware of your living situation and reasons for it? They need to know what the environment is for her at home normally so that they can plan for whatever supports she will need when she is discharged.

Is your wife in a secure unit?

[Cat Familiar]

What if she doesn't have the option to go home? She's not safe living there by herself.

[boatingwoman]

I take adderall. IMHO, if she is in medical detox, it is because 1) she was abusing adderall with high doses and/or 2) she has a drug problem you don’t know about.

[stolencrumbs]

I take adderall. IMHO, if she is in medical detox, it is because 1) she was abusing adderall with high doses and/or 2) she has a drug problem you don’t know about.

I know she was moved there because of a positive test for amphetamines. She still has most of her providers in another state, where we moved from, and it took longer for them to get medical records to confirm that she was prescribed adderall. She is prescribed 30mg a day, and has been taking that since she was a teenager. I don't know how much she actually takes. It very well could be more than the prescribed dose. I know that any suggestion I've ever made that maybe she should not take that, or not take that much, is met with a lot of hostility.

[boatingwoman]

From what doctor does she go get her monthly prescription?

[boatingwoman]

To clarify, adderall can have no refills, and cannot be called in.

This means if she was taking her adderall legally, once a month she was driving to a doctor’s office, picking up a hard copy prescription and then going to the drugstore to get her one month supply.

(From what you have described. Imo. There is no way she should have been on adderall)

[AskingWhy]

SC, I can't add to what others have said, but I am so relieved for you that at least your W is under medical supervision.  It's up to you to make sure your wife is safe and has the treatment she needs.   

[stolencrumbs]

To clarify, adderall can have no refills, and cannot be called in.

This means if she was taking her adderall legally, once a month she was driving to a doctor’s office, picking up a hard copy prescription and then going to the drugstore to get her one month supply.

(From what you have described. Imo. There is no way she should have been on adderall)

Yes. It is her pcp. We only moved an hour away, though it is in another state. She does go monthly, or close to it, to get the prescription. I don't think she takes the prescribed dose daily. So she sometimes will take one or two 10mg tablets, and other days will take three or four. I agree she should not be on adderall.

She partly takes it because she is worried about her weight and believes she gains weight when not on adderall. This is also a reason she doesn't like taking anti-depressants. I have assured her in every way I know how for years and years and years that I'm all about her being full-figured and alive.

[formflier]

It's likely a good idea to let her current hospital staff know contact info of her providers out of state.

All her medical providers should know she has been hospitalized.

Best,

FF

[sweetheart]

My dBPDh is prescribed an anti-side effect medication called Procyclidine. He has in the past misused it because it has the same stimulant feeling that amphetamines give. He used to abuse amphetamines as a teenager and still chases that feeling. When he misused this medication he had some of the worst dysregulations of all that he ever had. There was no build up he would just explode. He was also brittle and irrational all the time, like he might crack and break at any moment. It was a grim time.

Without careful monitoring and support from a psychiatrist working in addiction, stimulants and mental illness just do not mix. Stimulants and personality disorders IMO create a perfect storm of ongoing dysregulated behaviours.

formflier makes a really good point of letting her adderall provider know that she is in hospital, and informing her current clinician of her prescription details.
Joined up communication where addiction is an issue is vital to better outcomes.
If you know of any other doctors where your wife maybe getting additional pxs from or suspect that she is, say so. Tell them how often and much she drinks, they can then put her on an appropriate detox regime so she isn't in too much discomfort.

[Notwendy]

Are you in the US? I think controlled substances are registered electronically now. Some states that are near each other share this information. Her health care providers can look up this information. I think it's a good idea to let them know she is getting medication in another state.

Surely the center is aware of this registry and uses it with their patients. This may be a reason she is in detox now. But you should them know about her sources of medication in case they don't have access to the other state records.

I think it is important to also let them know about your living situation. I ran into this when my father was ill and had surgery. The hospital staff assumed he was returning home where his wife was a competent caregiver for him  and both he and BPD mom presented the situation like that. I felt that he needed more home help and they needed to know this.

The hospital staff may assume- or get the impression- that your wife would be discharged home to a more compatible situation than you have now.






 

[boatingwoman]

The good news is that she is getting taken care of and it seems they are taking this seriously. This started on June 4, so they have managed to keep her longer than 72 hours.  This is very good.  She needs to display her regular behaviors to them.

Also, in the beginning you were concerned about the Valium. They had to treat and turn off her brain, like an alcoholic who needs to detox. They can’t involve her in treatment while she is on a manic or a disregulation, etc.

Have they said anything about a hearing to keep her longer? I wonder if going to the hospital doesn’t count in the 72 hours (see Baker Act).

You are doing the right thing, SC.  I am proud of you for sending authorities when she pushed your hand.

I also hope you see that it comes across that you are afraid of your wife.  You are afraid of the fallout. Etc. You deserved a better marriage, one where each person brings 100% of themselves, each whole, to the relationship.  But, perhaps, I am pushing too much about this right now. I just wanted you to know that in the 3 threads, it seems very apparent to me that you are afraid of her.

Stay calm and resist the urge to get her out of inpatient treatment. She is where she needs to be.

Offhand question that is ultimately not important— just curious because I can’t visualize it... with her previous head injury, if the plate hit her between the eyes, how did that cause spinal fluid leaks? Thanks, but no need to answer. It’s not important... I just couldn’t imagine how that could happen.

[stolencrumbs]

The good news is that she is getting taken care of and it seems they are taking this seriously. This started on June 4, so they have managed to keep her longer than 72 hours.  This is very good.  She needs to display her regular behaviors to them.

Also, in the beginning you were concerned about the Valium. They had to treat and turn off her brain, like an alcoholic who needs to detox. They can’t involve her in treatment while she is on a manic or a disregulation, etc.

Have they said anything about a hearing to keep her longer? I wonder if going to the hospital doesn’t count in the 72 hours (see Baker Act).

You are doing the right thing, SC.  I am proud of you for sending authorities when she pushed your hand.

I also hope you see that it comes across that you are afraid of your wife.  You are afraid of the fallout. Etc. You deserved a better marriage, one where each person brings 100% of themselves, each whole, to the relationship.  But, perhaps, I am pushing too much about this right now. I just wanted you to know that in the 3 threads, it seems very apparent to me that you are afraid of her.

Stay calm and resist the urge to get her out of inpatient treatment. She is where she needs to be.

Offhand question that is ultimately not important— just curious because I can’t visualize it... with her previous head injury, if the plate hit her between the eyes, how did that cause spinal fluid leaks? Thanks, but no need to answer. It’s not important... I just couldn’t imagine how that could happen.

Yes, the time they are legally permitted to hold her did not start until she was admitted to the psych hospital. So the clock on that started on Wednesday. Five days is the maximum without getting a court order in my state. It appears that 5-7 days is the normal stay at the facility she is at, with the sixth and seventh days being "voluntary." They basically give patients the chance to stay voluntarily or they get a court order, and most just choose to stay. I don't know what my wife will do if presented with that.

I do see how much fear I have of her and her reactions. Kind of makes me sick to think about how long that has been the case and how deeply that is ingrained into my thought pattern.

Spinal fluid is actually cerebrospinal fluid. It covers the whole brain. It's common to get a CSF leak from a nose injury. The cribriform plate is back there, and it is a really thin, spongy bone. That is where her csf leak was coming from.

[boatingwoman]

Another thought is, she could have been getting extra adderall from Mexico or India.

[boatingwoman]

Ok, thanks for that tidbit about the fluid.  I have heard leaks are very painful.

My swBPD is married to a man who has been sanctioned more times than I can count. (Which is odd because whenever he gets committed, she is acting up very badly so we don’t know who is the one needing commitment, other than it usually seems she does too, so maybe both, but I digress).

He has attended a hearing twice in my state where they were able to get him a stay longer than the 3 days in my state.  One was 7 days and one was 10 days.

[stolencrumbs]

I just spoke with the doctor for the first time. He seems to think she will be released in the next couple of days. He thinks she is moving in the right direction, appears to be open to treatment, and has stopped minimizing what happened. I did give him more background information and history, explained our living situation, and expressed my concerns about her coming home. A lot of that was information he did not have. He is going to recommend their intensive outpatient program, which is three times a week for three hours a day for 6-8 weeks. I'm not sure how open my wife will be to that. I guess we'll see.

[boatingwoman]

That is what the doc was thinking before you supplied him with correct information. If she withheld information or lied (for instance about your living arrangements), then that might change things.

But mental health care, including that provided through commitment is not where it needs to be, so she might be getting out in a few days.

You are just going to have to keep calling authorities when she is a danger to herself, the house, the dogs or people in the community.

[formflier]

A lot of that was information he did not have.

Is there any information you think he should have that he does not have...now that you have spoken to him.

Glad you had a conversation with him.

What will you do if she is released and is not "open" to follow her doctors plan?

Best,

FF

[Gemsforeyes]

Hi SC-

I know given the circumstances you’re doing the best you can.  For a long time you’ve been operating on too little sleep and in constant crisis mode.

Maybe I’m living in a fantasy, but I wonder...  before they release her, is it possible for you and your W to meet privately to talk, where the doctors OBSERVE, say behind a window or something?  I’m just wondering if there’s any chance for them to see how a conversation between the two of you goes before they release her.  The reality of the situation, and the potential for the blame. 

I’m not trying to scare you, I’m sorry.  You stated previously that her parents will be present when she arrives home.  Is that still the case?

At this point, are you actually considering staying in the marriage home when she is released?  Do you want to talk about that and how that feels for you?

It’s good that you acknowledge your fear of your W and her behavior.  This would be a helpful topic for you to address with your T.  Remember yourself.

Warmly,
Gemsforeyes

[stolencrumbs]

Hi SC-

I know given the circumstances you’re doing the best you can.  For a long time you’ve been operating on too little sleep and in constant crisis mode.

Maybe I’m living in a fantasy, but I wonder...  before they release her, is it possible for you and your W to meet privately to talk, where the doctors OBSERVE, say behind a window or something?  I’m just wondering if there’s any chance for them to see how a conversation between the two of you goes before they release her.  The reality of the situation, and the potential for the blame. 

I’m not trying to scare you, I’m sorry.  You stated previously that her parents will be present when she arrives home.  Is that still the case?

At this point, are you actually considering staying in the marriage home when she is released?  Do you want to talk about that and how that feels for you?

It’s good that you acknowledge your fear of your W and her behavior.  This would be a helpful topic for you to address with your T.  Remember yourself.

Warmly,
Gemsforeyes

Yes, her parents are still planning to come, though it's not clear when they will be able to. If she had been released over the weekend, they would've been here. My sister-in-law is also in bad shape--liver failure, alcoholism, prescription drug abuse--and has been in the hospital this week. It's not clear when her parents could come up.

Yes, it would be helpful to try to sort out how I feel about living here. That is what my wife is telling me she wants now. And it's what she wants me to be telling the doctor.

I saw her today after I spoke with the doctor. I feel like NotWendy's experience is very helpful and insightful here. Apparently the doctor was prepared to release her today before talking to me. He doesn't seem to have much tact, as he pretty told my wife that. So, as you all predicted, she now feels like I betrayed her because I gave him more information than she wanted me to give. All the nurses tell her she's wonderful and shouldn't be there, and that's the main input the doctor gets on how she's doing. She is smart, and warm, and kind, and all the things she is when she's not talking to me after dark. Anyway, after talking to me, he decided to keep her another day and wants her to get an injection of the anti-psychotic he was going to prescribe orally. My wife really doesn't want to do that, and I'm not so keen on it either. My wife just called me and wanted me to look up prescribing information and side effects of this drug (it's aripiprazole.) What he is prescribing is way out of whack with the prescribing information. So she doesn't want to take it. She wants us to talk to the doctor together, because she thinks he is prescribing this to try to appease me.

I don't know. I don't know what to do. I don't know what to do when she gets home. I don't how much time I'm supposed to spend here. I don't know much at the moment.

[formflier]

Talking together is  a WONDERFUL idea.

Let her say her truth. YOU say yours.  Don't hold back at all.  She won't.

No more secrets.  Remember that mantra.  No more secrets.

Flip it about the doctor.  Be glad he told her.  You should own it.  He should own it.  Your wife should KNOW it.

No more secrets...(keep the mantra going!)

Best,

FF

[empath]

SC, my h says that he "gives people what they want" (aka. manipulates situations to his advantage) - that has led to him intentionally misrepresenting the environment of our home to many people. He has also felt betrayed when I told the truth about our situation and the things that he has done to me and the kids. He has threatened me because I betrayed him. He has also triangulated with people in authority outside our marriage and got them to turn against me. He can present in ways that seem very "normal" and gain sympathy from people by playing the victim.

I'm glad that you told her doctor the truth about your living situation. He probably needed to be open about what you had told him with her - it's one of the things about the mental health profession. I think it's a good sign that he had different thoughts about releasing her after talking to you.

I don't think I would meet with her and the doctor. At this point, it's not likely that she's going to be completely honest with the doctor because her goal is to get out. She has been a danger to herself and to you for a long time.

[formflier]

I don't think I would meet with her and the doctor. At this point, it's not likely that she's going to be completely honest with the doctor because her goal is to get out. She has been a danger to herself and to you for a long time.

Empath,

Do you think the doctor seeing the dramtic contrast would be a good thing?  That's where I was going with it.

Best,

FF

[Cat Familiar]

This thread has reached its maximum length and is now locked. The conversation continues here: https://bpdfamily.com/message_board/index.php?topic=337112.msg13057019#msg13057019