Monday, 18 February 2019

Music Hath Charms: "Post Traumatic" **Trigger Warning**

**Trigger Warning: language, suicide, alcohol/drug use**
For many music fans, 20 July, 2017 will be a day of remembrance due to loss of Chester Bennington. Knowing the impact his death by suicide has had on me personally, as well as many Linkin Park fans, I can't imagine the grief suffered by his bandmates.  Since the death, many musicians have spoken up about their feelings and have dedicated songs and performances in his honour.  Not much has been heard from the survivors of Linkin Park as a whole, but band member Mike Shinoda released a solo album, influenced by his attempt to understand and continue to move forward in light of the loss.  The album 'Post Traumatic' contains stirring lyrics and heart-wrenching music throughout all the songs.  Released as a whole on 15 June, 2018, tracks from the album were pre-released as early as 25 January, 2018, and in December 2018 2 more tracks were included in a release to vinyl.  In total, there are 18 songs that play, with many artists performing songs with Mike.  Like my other music posts, I'm going to take my favourite lyrics and share them with you. This time around, I'm going to try and include my reasons for choosing those particular lyrics. Please let me know if that is something I should continue or if it just adds too much information.

Lyrics are from:
Use the link if you'd like to see the full lyrics for the songs I've chosen or to see what else is on the album.  The music is amazing and powerful.  I hope you enjoy it as much as I do.

Over Again
Post Traumatic (2018)

It was a month since he passed, maybe less
And no one knew what to do, we were such a mess
We were texting, we were calling, we were checking in

How do you feel, how you doing, how'd the show go?
Am I insane to say the truth is that I don’t know
My body aches head's spinning this is all wrong
I almost lost it in middle of a couple songs
And everybody that I talk to is like, “wow
Must be really hard to figure what to do now”
Well thank you genius, you think it'll be a challenge
Only my life's work hanging in the fucking balance
And all I wanted was to get a little bit of closure
And every step I took I looked and wasn't any closer
'Cause sometimes when you say goodbye, yeah you say it
Over and over and over and over

I'm in no way famous, but when a friend of mine completed suicide in her home (one town over from ours), every time we drove through the memory was there, and it really was a matter of having to say goodbye each time.  Up until the time we left I had not reconciled the feelings present.

Promises I Can't Keep
Post Traumatic (2018)

What's the difference between a man and a monster
Is it somewhere between "I can" and "I want to"
Is it somewhere between the promises I made
And the fact I couldn't see something getting in the way

I used to think that I know what I want
Never saw it coming unglued
I used to think that I know what I want
Now it's time to see if it's true

I had so much certainty
Till that moment I lost control
And I've tried but it never was up to me
I've got no worse enemy
Than the fear of what's still unknown
And the time's come to realize there will be
Promises I can't keep

[Verse 2]
What's the difference between a loss and a forfeit
I tried to make it better, but I made it more sick
I tried to make it right, but now awake at night
I know reality was getting in the way

I've thought long and hard on the line "Is it somewhere between 'I can' and 'I want to'" and which side of the coin equals man or monster.  I have spent a lot of time in the 'I want to' realm, but only get concerned when I crossover to the 'I can' side of things.  I rarely have much certainty, but when I do, losing control feels like the worst thing in the world.  There have been many times where I thought I was well enough to tackle something but ended up with 'promises I can't keep'.

Crossing A Line
Post Traumatic (2018)

I don’t know how to warn you
For what I’m gonna say
'Cause you’re holding so tight to
What I’m taking away

I got demons inside me
So I’m faced with a choice
Either try to ignore them
Or I give them a voice

And it’s keeping me up at night
Worried it’s not alright
Holding back things you don’t know
And it’s keeping me up at night
Worried it’s not alright
You’re not gonna like where this goes

It's much easier some days to ignore the demons inside and try to not let others be hurt by them than it is to give them a voice, where you let everyone know how much you are hurting.  The internal debates can definitely keep you up at night; trying to come up with the best solution that will include honesty but not cause your loved ones to worry is a hard line to know when to cross.

Hold It Together
Post Traumatic (2018)

She said, "Are you okay?"
And I'm staring into space
It's making her nervous cause one thing is certain
I don't have my head on straight
We're trying to get through each week
On two or three hours of sleep
I say to be patient
That we're going to make it
I have to admit that I'm struggling

They say take it slow
But the world keeps spinning
And that I don't control
And so there I go
Trying to act normal
So they won't know that…

I'm just trying to hold my shit together
Together, darling
I'm just trying to hold my shit together
Together, darling

Staring into space, listening to all the noise that's in your head, and as sleep decreases the volume gets turned up until it's deafening.  Getting to the point where I can admit I'm struggling is a huge leap in trusting those around me (but they usually know I'm slipping before I say anything).  Keeping up appearances for as long as possible, and hoping that those outside of my immediate circle don't know anything is wrong seems to be the most important thing in the world.  Sometimes holding my shit together is a full time job and completely exhausting.

Make It Up As I Go
Post Traumatic (2018)
Featuring K. Flay

[Intro 1: K.Flay]
I keep on running backwards
I keep on losing faith
I thought I had the answers
I thought I knew the way

My brother said be patient
My mother held my hand
I don't know what I'm chasing
I don't know who I am

[Verse 1: Mike Shinoda]
Woke up this morning holding my head
Thinking last night is one I'll regret
Washing off the bad decisions, the blurry vision
The clues that I'm still a mess

Spitting out the taste I have in my mouth
Knowing what this all is really about
Knowing there's an explanation, an expiration
I gotta figure shit out

[Pre-Chorus: Mike Shinoda]
And they're asking me if I can see
The darkness down below
And I know it's true, I say I do
When half the time I don't

It's so easy to try and run from what we don't understand and don't want to feel, and sometimes that leads to things we regret when we're stronger or awake.  There is a darkness that is easy to fall into, and sometimes we don't see it until it's too late.  The path unfortunately is not straight forward, and I know I've taken as many steps backwards as forwards at times. But I'm told I have to give myself credit for just keeping going.

Running From My Shadow
Post Traumatic (2018)
Featuring Grandson 

[Verse 1: Mike Shinoda]
Wanna know where I don't go
When it goes from "okay" to a "oh no"
When it goes from hi five to a low blow
When it goes from all five to a solo
Lemme tell you what you don't know
I been down, so low, I was
Looking for something but denying that I found it
There's an elephant sitting in the room
And I can't find another way to tiptoe around it
I been doing greater good for a long time
But I can't find any other way to give now
I been putting myself on the sideline
And it's been time so I'm saying can I live now

There are times when I kick myself
Say I'm not sick but I can't get well
Say I got this while I chase my tail
As if they can't tell

[Chorus: Mike Shinoda]
I'm running from my shadow
Running from my shadow but it's still there chasing me down
I'll never win the battle
Never win the battle and I should have known it by now
Just when I think I've found the end (Oh)
I'm going back around again (Oh)
Running from my shadow
Running from my shadow but it's still there chasing me down

Sometimes, I think we chase our shadows, and sometimes they chase us.  There are always those times where things seem to be going well, and then something major comes in and kicks us back into the mess.  Admitting that we may be sick with whatever type of mental illness we have is a hard thing to do, but it has to happen to try and get well.  It doesn't matter how many go-arounds it takes, we will always be in the chase. It's just a matter of who's leading.  After something traumatic happens, I do think people tend to go into a holding pattern, but at some point, life has to happen again so asking the question can I live again is huge.

Nothing Makes Sense Anymore
Post Traumatic (2018)

I used to sleep without waking up
In a dream I made from painted walls
I was a moment away from done
When the black spilled out across it all
And my eyes were made sober
World was turned over
Washing out the lines I’d seen
And my heart is still breaking
Now that I awaken
No one’s left to answer me

My inside’s out, my left is right
My upside’s down, my black is white
I hold my breath, and close my eyes
And wait for dawn, but there’s no light

The truths we face in our sleep can be very different from what we show on the outside.  Mike Shinoda is extremely creative in many genres.  He has done wall sized paintings for outdoors exhibitions, so imagine being almost done and then black paint spilling across all of it.  I think those who are creative in some ways have easier ways to express what is going on in their head but I think they are more susceptible to something coming along and erasing it.

World's On Fire
Post Traumatic (2018)

Don't think I need to say this
'Cause you know what's in my head
"Fucked up" is an understatement
Can't wait for this year to end
It all fell apart, don't know where to start
And everything moves so slow
I can't get a break, it's too much to take
But closing my eyes, I know

When the world's on fire, all I need is you
I don't always think to say it but it's true
When I just wanna disappear, you're the one that keeps me here
The world's on fire, all I need is you

It doesn't matter if it's a year, or many years, out there is always a part of the brain that is "Fucked Up" after losing someone to suicide.  Having a person or two to turn to can make all the difference in the world.

Can't Hear You Now
Post Traumatic (2018)

Run, run it back, tell 'em what I'm coming at
I was on that bullshit then, now I'm done with that
Scared of what I didn't want, scared of what I wanted
And thought that I was finished but I hardly had begun, in fact
I'm a beast, I'm a monster, a savage
And any other metaphor the culture can imagine
And I got a caption for anybody asking
That is, "I am feeling fucking fantastic"

Some days, it doesn't take much to bring me down
Some days, I'm struggling for control
Some days, it doesn't take much to bring me down
Right now, I'm floating above it all

There is a point in healing that their voice isn't always echoing in your head and you start to move on.  I think for someone who is so in the spotlight there will always be people who don't feel like they are mourning correctly, or for long enough, and that is where you just have to say it doesn't matter what you think "I am feeling fucking fantastic" and be okay with that.

Mike Shinoda put out this amazing album which gives a window into what he went through when he lost his friend Chester Bennington to suicide.  I feel like the album also helps those of us who are trying to heal from the loss of someone close to suicide.  For me, this album is a reminder of how much pain those closest to me would suffer if I committed suicide. So as bad as I feel at times, I know I can't do that to them.  I don't know if Mike knew he would save lives by sharing his pain through music, but I know I'm at least one who is being saved by listening to Post Traumatic.

Take Care!

Thursday, 14 February 2019

GP Surgeries and Hospital visits

If you asked anyone who knows me for a description of me, I think most would say I'm complicated, especially when it comes to anything (and everything) medical.  We knew that in coming here the medical system would be completely and drastically different from anything previously experienced,  starting with the reality of a National Health Service (NHS).  Imagine having almost everything to do with the body included within one system that does not require separate and expensive insurance policies.  As a citizen of the UK, a person is automatically included in the program and care is provided at no cost (except for some prescription and dental charges).  As guests here my husband and I had to pay for access, as part of our visa fees.   Once we did that, though, all of my GP visits, psych team visits, and hospital testing and stays are included.  So far I have more than gotten my money's worth with the care I've received and it's only been since September.

To be seen by a GP you must register with their practice.  Once registered, a primary GP is assigned to you even though you may or may not see them most of the time (seems to be a NHS requirement).  Most GP surgeries (offices) have multiple doctors of varying levels and specialties, and many have nurse practitioners that can be seen as well.  The GP acts very much like a primary care doctor does in the United States.  They are the hub for all of the specialists to work through, and they approve or send in referrals, and handle/manage the prescriptions.  The practice I'm a part of has more than 13 GPs (spread over two locations) and has a few Nurse Practitioners as well.  There are also 2 pharmacists that work with the doctors and patients to manage medications but they can also prescribe medications when appropriate.  There is an online portal that can be used to request appointments and medication refills, and it also allows you to see who has accessed your medical records.  If you are really adventurous you can also request an e-consult.  By answering some basic questions they decide what to do and promise to call back within 24 hours to tell you if you need to be seen, get a prescription, or just follow their advice.  Because the number of patients is so high and appointments are at a premium, they are scheduled in 10 minute intervals and if more than one topic needs to be discussed you must request a double time slot.  So far I have not run afoul of the time limit but I have not had too many appointments with a GP yet.  Routine appointments may be scheduled a few weeks out, but the staff have the ability to triage you into a sooner appointment if your condition warrants it.  Treatment by the GP is fully covered by the NHS so no copays are required.  Most of the time the appointments are right on time or very slightly late.  The only exception seems to be if you come into the office and request a same day appointment then the wait can be quite long because they will be slotting you in when a break in the schedule allows it.

Included in the building that holds my GP surgery is a walk-in clinic that can be used if you are experiencing something very basic that can be treated by either an advanced practice nurse or their equivalent.  This sure beats going to an A&E (ER) and waiting for a really long time to get the same treatment.  Like any government service, the NHS is underfunded and overwhelmed but it also has better service than I experienced in the United States.   Universal healthcare seems to be a dirty phrase in the US but so far the advantages far outweigh any drawbacks.

I have had a quick 1 day/2 night hospital stay relating to my mental health that required me to be monitored while IV medications were given.  Because of the NHS all of this was done at no cost to me, including a chest CT, many vials of blood, constant monitoring of heart rhythm and blood pressure.  The results of my ECGs were abnormal and because I had been experiencing intermittent chest pain a cardiologist was called in and decided to do further testing on my heart.  Within a couple of weeks of my discharge I received a letter telling me to report to one of the many hospitals in the area and have an echocardiogram done.  Later that week another letter came with an appointment set up for more specific CT's of my heart and the vessels leading into and out of it.  Both rounds of testing have been completed at this point and again all of this was done at no cost to me (other than the Uber to get to and from the hospitals). Fortunately all tests look great and I can be done worrying about my heart and just worry more about other things.   My tests were completed at Freeman Hospital, and my original stay was at The Royal Victoria Infirmary (RVI).  It seems that with multiple hospitals in a relatively small area they specialise in certain things instead of having all of them doing the same things.  So for an emergency I was taken by ambulance to RVI because of it's A&E, but the testing on my heart was done at Freeman because they have a specialised cardiothoracic centre.  I know if it becomes necessary to have an inpatient psychiatric stay that will be at another hospital.  This is so much better than having multiple hospitals in an area all doing the same things and trying to one up each other instead of focusing on what they do best and working together.  So for both inpatient and outpatient treatment I have had amazing experiences, and the waits are no longer than what it would take to be seen by most US specialists.

My next big encounter with medicine will be at my evaluation by the Pain Clinic at RVI in mid-March.  I've been counting down to this appointment pretty much since we received a letter saying where and when to show up and a packets of papers to complete before the appointment.  In our corner of Colorado there were no pain specialists and my various doctors did their best to help me cope with chronic pain from multiple sources.  I hope I'm not putting too much hope for answers and treatments into this centre.

I'm happy to keep my experiencing of the hospitals in this area to the three I've been to or know about.  The other six that are technically in the area but are a little farther afield can stay unvisited, although we've passed one of them multiple times walking up from Quayside. (It's a hospital in name only, but has an amazing history if you want to look into the Holy Jesus Hospital).

The practice of medicine is pretty universal, but the culture from which that practice originates can make all the changes in the world.  It's been good for me and I think I will find answers to questions I've been asking for a very long time.


Monday, 11 February 2019

From Point A to Point B

When you live in a small town in the United States, your options for getting around are pretty much limited to walking or driving a personal vehicle. Of course, this varies with the size of the town and basic infrastructure.  Owning a car is considered by many to be a necessity even if it is never driven farther than the local corner store to pick up beer and 'smokes'.

In Colorado, it is common to take a trip for shopping or Dr. appointments that can be as long are 3-5 hours one way.  Denver is the hub for all things medical; it's where the big hospitals, the teaching hospitals, and the majority of the rarer specialists are located.  Denver also has more malls than anywhere else, so it does bring in long-distance shoppers, especially around special occasions or holidays.

It is possible (and frequent) that on a long road trip you can go for an hour or more without passing more than trees, fences, an occasional house (in the middle of nowhere) and lots of cows and other wildlife, depending where you are at (deer, elk, antelope, mountain goats etc.).  Small towns start to get more frequent as you approach many cities and at the base of the mountain passes, it is often prudent to stop before making the drive up and over.  On trips that are made frequently you learn where all the best places are to stop for a quick top off of the tank, a boost of energy through a snack or drink, and most important where the last chances are to visit the loo for a more comfortable ride.  In Colorado, weather also factors into these plans, making a quick hour-long hop to the next town easily turn into an unpleasant trek that takes infinitely more time, and at night gives you the impression of jumping into warp speed as the snow flies towards your headlights.

When we moved here to Newcastle we knew we were not going to get a vehicle, and had no interest in learning to drive, especially because of the incredibly complicated roundabouts.  We are always impressed watching our Uber drivers manage the directions on their GPS (talking about 'taking the third left in the middle lane but tending to the right' and around the circle) and miraculously we come out where we are supposed to be.  Uber has been a lifesaver for those times that are either just awkward timing to get someplace on the bus network, or when travelling to and from the Central Station with enough luggage that juggling it on a bus would be difficult and walking there is not worth the stress.

My husband has become an expert at getting around by bus. My last experiences with riding busses were as a young teenager, too young to drive but wanting to explore the city with my best friend. Since then I've relied on getting places by car.  There are multiple companies that run buses that stop within a short walk of our flat.  The difficulty is figuring out which bus, heading which direction, and where the closest stop to our ultimate destination is going to be.  David relies on Google maps and their public transportation option to help figure out where and when to hop on and then counts down the stops to where we need to get off.  We do have a few routes that we have taken often enough that I've learned the landmarks to watch for and that let me know when I'm about to reach the final stop to disembark at.  Except for these main routes I am scared to death of getting on and heading the wrong direction or miscounting bus stops and ending up way off target.  For now these anxieties keep me from traveling alone but I will soon have some help in learning how to make the system work for me and not be scared to death of exploring the city apart from the areas around my flat.

I have a goal for early March to get from our flat to a local clinic where I will be attending some therapy groups.  It would be over an hour to walk there and the route seems quite complicated or I can take one of 3 bus routes to make it there in about 40 minutes and only 10 of those would be walking.  I know what I have to do, and will spend the month of February gaining confidence in getting from Point A to Point B.  If I get lost somewhere between here and there then it will be Uber to the rescue, and a dose of anti-anxiety meds while I wait.

When we travel further distances we hop aboard any one of the many trains that are heading in the right direction.  If we are heading far afield (like London, Liverpool, or Edinburgh) we will pre-purchase tickets and whenever possible choose seats that allow us to face the direction of travel (motion sickness from riding backward is not our friend).  For quick day trips we just purchase tickets at the station and since many of these trips are less than 30 minutes we are just fine if we can't find open seats and instead 'train surf' as my daughter called it.  Some of our trips to London have been amazingly quick, with less than half a dozen stops between here and there, while other trips seem much longer because we stop at every little town/city on the route.  Google Maps shows the distance between here in Newcastle and London as being right around 280 miles (450.6 kilometers) and taking about 5 hours to drive. Compare that to a trip we made frequently between Craig, CO, and Denver, CO, with a distance of 198 miles (318.65) and taking about 3 hours and 45 minutes to drive.  The biggest difference between the two is the number of towns you encounter along the way.  For the Colorado trip, there would be roughly 9 chances to stop, or at the very least a need to slow down for a short distance (this is not counting all the suburbs of Denver that some may claim are independent towns). Based on Google, there seem to be 15 places where the road travels through or very close to a town (again not counting all the suburbs of London). 

We've come from the land of everyone owns a car (or at least a majority) and considered having all the adults in the household capable of driving (even if just around our small town) as a necessity, and have now landed in the perfect spot that allows us to walk for most of our necessities. Instead, we've come to a place with a robust public transportation system.  So instead of firing up our TARDIS (the nickname for our blue Toyota) every time we wanted to go anywhere we can now hop on a bus (or train, or metro, or Uber) to get from Point A to Point B.


Thursday, 7 February 2019

The Parent Trap

In 1997 my husband used my family's tradition of opening one big gift on Christmas Eve to propose to me in front of all of them.  We set our wedding for October of 1998 and worked on getting things together.  One of the big discussions we had was about having children and we decided that yes we would have kids (eventually), we would aim to have 2 kids (twins run in my family so we were kind of rolling the dice on a second go around), and that we would name a boy William (a name popular on both sides of our families) and a girl Jessica Anne (the 'e' was very important).

The plan was to wait "awhile" after the wedding to start our family and we talked about travelling to Egypt, Europe, the UK, and anywhere else we had ever dreamed of visiting.  We knew that we would try to do things very differently from our families of origin (staying together and not marrying psychopaths were on that list).  In general we acknowledged that we had no clue how to be good parents but we would try to not "f*ck up the kids" to the best of our abilities.

October 24, 1998- Came, went, was absolutely amazing, beautiful, and just about perfect (a little issue with massive amounts of Grand Marnier in the frosting of the cake being the biggest hitch).  One big thing was missing though, my period.  A few weeks later and still no signs of "Aunt Flo" and we popped out to the drugstore for a home pregnancy test.  SURPRISE it was +, tried a second one (just to be sure) and still +.  Okay, okay home tests are sketchy so I'll see a Doctor and still + (holy shit we have a little one on the way).

Parenting went from a theoretical to an onrushing conclusion in the space of 2 supermarket tests and a little bit of wee.  Our plans for Egypt were quickly squashed and arrangements for a crib, a place for the baby to sleep, and natural childbirth vs. C-section moved into its place.  When we were far enough along for the ultrasound to (relatively) accurately predict the gender of our rapidly growing lump we cheated and chose to have the doctor tells us.  It's A Girl and it's not twins (thank god).  We continued our preparations and in July 1999 our daughter announced she was finished cooking and ready for the outside world.  The plan was for a vaginal birth (epidural included please), but this did not suit our little girl and after quite a lot of pushing (and not getting anywhere) plans were changed to an urgent/emergent C-section.

She was beautiful but a little cone-headed because of all the pushing and like all babies she knew how to get what she needed day and night.  We learned fast and we all survived (and even thrived).  She hit all of her milestones and of course we thought she was brilliant and going to change the world (we still think she is going to change the world and she's doing everything possible to make those around her see the same things).

During our initial discussions about having children we decided that we wanted them to be fairly close together age-wise and not more than 3 years apart if we could help it.  So, sometime around Fall of 2000 I stopped my birth control pills and we let fate decide when our next child would come to us. It didn't take long at all when we figured out Child 2 was on the way.  Again we let ultrasound take a peek for us and our little boy was willing to give the doctor the perfect flash of parts to let us step up our planning.  Since the birth of our daughter was fairly traumatic for all involved we decided it would be safer to schedule a C-section (all measurements showed William was going to be bigger than his sister so caution made sense), and by having all of my 'lady' parts hanging out after he was extracted it also allowed them to quickly and easily 'tie my tubes' to prevent future pregnancies.

Our son was beautiful, amazing, and loud, and with his birth I was now mom of a newborn and a toddler (what were we thinking) and learned the art of juggling like a pro.  By this time we were living in a very rural part of Colorado but made frequent trips to town to give them chances to socialise before they were old enough for school.

My daughter was fairly healthy but needed a couple of surgeries to fix some common childhood issues.  Her brother decided to make things more interesting by having some pretty complicated medical and behavioural issues that kept us on our toes and making frequent trips to town (an hour away) and to Denver (2 1/2-3 hours away) for specialist visits.

The local school was small enough to be Pre-Kindergarten - 12th grade in one building and was where my husband had started teaching.  At one point my whole family was together in the same school for a majority of the day.  Both kids did great in school and really thrived in the small class sizes.  After my husband completed his Master's degree we moved to a whole new corner of the state and into a "real" town with less than a mile between houses and even a McDonalds (amazing how easily amused we were).  The kids moved into much bigger schools and my daughter adapted no sweat but things were a little rougher for our son because of his special needs (but he did okay to start).

Being in a small town suited us all and made getting services for Will much easier.  We still took frequent trips to Denver for specialists (now 4 1/2-5 hours one way) but his day to day medical care could be handled a few blocks from home.  Will was also able to get involved with Special Olympics as an athlete in multiple sports (track and field, bocci ball, and bowling) and Jessica became a youth leader(?) and helped him and the rest of the team when she could.  They made an amazing pair and she was the best at reading him and knowing when he was running out of energy or getting overly excited, and she knew the easiest ways to intervene.

School was a place our daughter excelled!  She even used a program of concurrent enrolment that was offered between the high school and the local community college to graduate with both her high school diploma and an associates degree, all within a week or so of each other.  She also participated in multiple extracurricular activities through the school and continued to help with Special Olympics. She has gone on to University (the same Uni her father and I met at -- small world huh) working her way towards a history degree and certification to teach special education (told you she was going to change the world).  Just this term she is starting her student teaching, working on her senior thesis, and working as many hours as possible at an on campus job.  She will finish in Spring of 2020 and will go on to even greater things than she has accomplished so far.

School for William was a place to go, be with his friends, and learn some social skills.  Educating him is a huge challenge because he knows what he knows and those special things that excite him he knows enough that he can teach others about them (if you can keep up with him).  If it's not exciting to him or not presented in the perfect way it just does not make it through his filters, so it becomes frustrating to all involved. The school district was also not equipped to take on his medical needs and from middle school on it became a constant fight just to keep him safe while there.  So we made the decision this past Fall that he was better off getting real world skills than rereading Animal Farm or continuing to fight to learn division, so we unenrolled him from public school.  He has been able to participate in a jobs program that has introduced him to some of the types of work available in town and he loved it.  He also interviewed and was hired for a position that will have him learn about a local attraction, and once tourists start coming back he'll lead tours of it.  At Christmas he was able to share a very lengthy introduction after only having read an article online.  He'll do great.  He currently lives with his grandmother and helps take care of her, the cats and the house.  In the Fall when he turns 18 we'll start looking for the best place for him to be whether that continues to be in the town he's in now or in a larger city that may have more resources that will allow him to continue to grow and live semi-independently at some point.  He is an amazing person and when you consider all that he has overcome it is truly remarkable.  He makes an impression on everyone he meets and is going to take on the world and leave a mark wherever he lands.

Parenting started for us like it does for all parents, I think, it was theoretical and of course we imagined the best case scenarios for our children but you know what we got better than that from both of them.  They have blossomed into amazing young adults and have so much potential for the future it's immeasurable.  They will leave a legacy that we never could have fathomed.  We started our family a little earlier than originally planned but what we ended up with could only have been provided by fate.  Jessica and William are moving out into the world beyond our day to day influence but they remain the best of us.  Our family is strong and has endured much and now we get to watch as they make their mark on the world around them.

Getting ready to go through TSA screening on their way to visit us for the holidays.

Monday, 4 February 2019

Medication and the Elixirs of Life

I originally started a post that was going to take on the whole of the NHS, medications and hospital visits in one go, but as you can imagine this turned out to be way too much for one post.  So I'm going to start with what I interact with most on a daily basis and work from there.

Because my Husband and I are here in this lovely country as guests, on a visa that allows him to study here for the next 3-4 years, we are not automatically included in the NHS but had to pay a very reasonable yearly fee (£150 per person per year) for coverage.  On top of this fee we purchased a prescription plan (£100 per year) so that my medications would be covered for the first year and that we will most definitely renew.

Medications are turning out to be one of the biggest challenges I've faced since arriving.  As soon as we knew for sure we were coming here we started reaching out to Drs we had corresponded with previously to find out how to make the transition as easy as possible.  We sent them lists of the medications I was taking and except for one that is available here but not used for the same reason it seemed like things were going to be okay.  We prepared for the lag time in meeting Drs and getting prescriptions sent in by arranging to bring 90 days worth of prescriptions from Colorado, so things were not desperate at any point in the prescription waiting game.

My first physician interaction was at my assessment by the Community Mental Health team. Towards the end of the assessment the Community Practice Nurse left the room with my medication list in hand and returned with the Psychiatrist who would be handling my care.  Right away I knew things were going to be changing dramatically with my medications.  She started out saying that two of my medications were not available at all in the NHS, both were ones I considered crucial but now I would have to work on weaning off of from my private stock. There were also concerns based on the extremely high doses I take of several medications, so one of the P-Doc's goals would be reducing those doses, ideally until I could be weaned off of them completely.  The goal for my psychiatric medications is to find ways to get me as stable as possible and start withdrawing medications in a controlled way so the weaning can be stopped at the first signs of increasing symptoms.  The practice of throwing meds at me hoping for improvement with more and more complicated treatment regimens is not the way things are done here (and I'm reminded it of frequently). Instead, I will be taught how to cope with symptoms and triggers and when I can take at least some control over my mental health the medications will be reduced and eventually removed.   I'm already on fewer medications than when I came here and lo and behold I'm improving, so maybe their system works.

On the physical health side of things, changes were made as well because again we were told that some of the medications I was on were not available at all or that are very rarely used and at different doses than I was taking.  It didn't seem to matter that the one thyroid med had made drastic differences in my mood stability when it was added around 9 months before we landed, they only had a higher dose available and it was not routinely used.  It is also a bad sign when the Drs, RNs, or Chemists can't pronounce the medication.  I have used pain medication for years because of my Fibromyalgia and osteoarthritis, with occasional dips into my stocks for my chronic headaches.  I had heard that low dose codeine paired with paracetamol would be available OTC here and so weaned off of the last of the narcotics when landed.  For most days a couple of doses of this Co-Codamol is enough to decrease my pain to the point I can be as active as possible.  I have been referred to a pain clinic for an evaluation and I'm just trying to make it until the mid-March appt and see if there are any new options.  I'm willing to try just about anything to keep my pain levels below a 5 out of 10 for most days, and manageable for the rest of the days.

When we first went into one of the local pharmacies to purchase basic OTC medications (paracetamol, ibuprofen, cold medicines) we were amazed by how little they cost.  A box of paracetamol with 16 tablets runs around 20 pence, and even cold medications are less than a pound. Other than the bottle of aspirin my husband brought home the other day all of the other medicines have been in boxes and the medications inside are the kind you push through the foil backing to get them out.  I haven't found a specific reason for this type of packaging for everything, but because while my son was visiting some of his tablets either exploded (kind of like popped kernels of popcorn) or melted (became sticky or just started disintegrating) our theory is that this kind of packaging protects the medication from the constant high humidity levels.  I kind of like the cards of meds they are much easier to pack in a bag either for a day trip or overnight.  The biggest exception to this is my medications that are delivered in a medi-box weekly.  The pharmacy prepares my medications for the week into daily compartments that are divided for morning, mid-day, tea time, and bedtime.  They then sort my meds into each compartment and a seal is put over the top that allows me to punch out the appropriate meds at their scheduled time.  It really is a handy feature and it allows my husband to not have to sit and sort meds for an hour or so each week.

The paper boxes themselves have a really cool feature in that there is braille lettering on all of them. No one in our family is in need of this feature, but having it there and that it is so universal is brilliant and is another area where the U.S. needs to catch up a little.

I've been told (repeatedly) that I am an anomaly to be on so many medications at such an early age, but it is what is necessary to keep me going and as healthy as possible.  Between my prescription meds and those we pick up OTC I'm on a regimen that helps me stay safe and satisfied with what is going on in life at any given moment.  The NHS has made caring for medications almost effortless and even the ones we add out of private stock are perfect cost wise and in availability.  I'm trying to prepare for a time when many more of my medications are withdrawn, but I'm trying to take it one day at a time.


Thursday, 31 January 2019

Hard Reset and Starting Fresh

The initial steps taken on my journey to England began over 15 months ago with much in the way of research and reaching out to the specialists that would see me through the harder parts of my illnesses.  At the time my husband first brought up the idea of studying here I was undergoing ECT (electro-convulsive therapy) treatments at least twice a month and at times when I was inpatient I was getting them  three times per week.  When we began looking at moving, there was no end in sight so locating a hospital in the area that could continue my treatments was crucial.  With a little bit of research through the NHS websites, a treatment program was found not too far from the University my husband was applying to.  We reached out to the main physician through email and when we came to visit the city (before making a final decision to move) we arranged a tour of the treatment centre.  Other than the age of the building (old Victorian era hospital), and that within the same building there were separate male/female inpatient units (segregated units are common here and sound amazing if I need the time inpatient), the treatment area was much like what I was used to.  There was a patient prep area where the IV and monitors could be hooked up before being brought into the treatment room where the anaesthetic was given before the seizure would be induced.

The preview trip itself is a blur but I know we came home and decided it was worth it to apply and then see what happened next.  It was no big surprise when my husband was accepted and then a few months later learned he would receive a scholarship that was the final piece to making the move possible.  What did come as a big surprise was that after returning home I completed a few more ECT treatments associated with yet another inpatient stay, and then the decision was made that the treatments were causing more harm than good.  October 31, 2017 I completed my last treatment and came home a few days later.

For me ECT was somewhat equivalent to doing a 'Hard Reset' on a computer.  The initial treatments did not seem to do a whole lot but with major tweaks to the positioning and amplitude of the shock my mood slowly improved.  ECT, even when done correctly, has a major side effect of disrupting memory, and whoa, did mine get disrupted!  A lot of the time it is the working memory from around the time of treatments that are most effected -- things like forgetting names, whether or not a medication had been taken, losing words mid-sentence, and whether or not a certain topic had been discussed with those around you.  When ECT is given with bilateral electrode placement, memory loss is usually worse, and the majority of my treatments required the bilateral placement.  Pro-ECT literature talk about this memory disruption being temporary and that when treatment is stopped the memory returns.  Anti-ECT literature liken the treatments to medically induced brain damage and that memories will be gone for good.  When you are profoundly depressed, manic, or psychotic you are not always in a position to do independent research prior to signing on the dotted line of the consent form.

My memory loss was so extreme that I was trialled on 2 Alzheimers medications to try and slow the loss of everything important to me (neither worked).  I retain random pockets of memories from my early years, and because life is cruel I remember much of the abuse that had led to my extreme depression and chronic suicidal ideation that brought me to the ECT centre.  Outside of those pockets my memory sucks, which means I've lost meeting and marrying my husband, the birth of my two children is largely gone, and most of the last 30 years.  At more than a year away from my last treatment I have lost hope of regaining any of it.  I do have improved word recall (sometimes) and with the help of reminders and alarms can manage most of my own medications (taking them but not prepping them), and can sometimes remember that I've had a conversation with my husband.

My brain has undergone its Hard Reset and now I'm working on starting fresh.  I'm rereading books that I know I've read (and maybe even enjoyed) sometime in the past to try and stimulate connections that may still be there.  I have always been a researcher of some sort so I'm going back to topics I "know" I excelled at and I'm starting at the beginning (most recently learning the basics of genetics, biology and philosophy).  I'm rewatching movies that had some significance in my life or that I enjoyed watching with my family (watching Disney movies with new eyes has been so much fun even if my husband/kids laugh at me).  I have been able to experience so many things with childlike wonder because they are fresh and new to me in my 40+ year old brain.  I write things down because they still get lost and there is so much from NOW that I don't want to lose.

I wonder if/when my depression worsens to the point of being unable to take care of myself or to keep myself safe if I would allow more ECT treatments to be done to get me back on my feet, but I really don't know.  I have to accept that the initial run of treatments (done while inpatient) brought me to a place where I was able to rejoin my family even if I was not really able to participate with them for awhile longer.  The treatments did that for me, but they robbed me of a large portion of my adult life.  I think that there really wasn't a good solution, but we pursued the best solution for the condition I was in.  Could I do it again?  The me of today says the cost is too high but if in a life or death situation I know how far ECT brought me before so I just might have to do it again.

Hopefully it doesn't come to that anytime soon.  Instead I'm focusing on learning coping skills that may bring me out of the darkness of depression, and building a support network that I can turn to when things get really rough.  A fresh start in a city with so many resources is my best treatment option for the present.

An interesting article popped up in my news feed this morning.

Take Care,

Monday, 28 January 2019

When Do We Eat and What’s on the Menu

In 'Lord of the Rings' Merry and Pippin like all good Hobbits are concerned about the meal schedule while they are travelling with Frodo, Samwise, and Strider.  After their breakfast is interrupted and being told they will travel as fast as possible to Lothlorien they ask about 2nd breakfast and Elevensies.  As humorous as this exchange is it is based (somewhat loosely) on actual traditional British meal times.

I experienced this for the first time while on a hospital ward at the Royal Victoria Infirmary.  At roughly 0600 the lights were turned on and a trolley was brought in with the offer of coffee or tea.  Not a bad way to wake up but somewhat unexpected (nothing like this happens in most U.S. hospitals).  An hour or so later we were all moved from our beds to one of the chairs next to them and breakfast was offered, this consisted of the choices of bread and jam or an assortment of cereals with milk.  Throughout the rest of the day trollies were brought around with snacks and meals (all with tea as the main drink option).  With the last offer of tea and a snack at 2100 (an hour I am usually asleep).  Upon coming home I started looking into why there were so many chances at eating throughout the day, it seemed excessive, and this is what I found.  These are not hard and fast rules but it has a historical aspect that hasn't totally been converted to the typical 3 meals a day.

Breakfast - ≈  0600-0900 (sometimes called Brekkie)
     Light foods such as bread and jam, cereal, porridge (oatmeal) with syrup and/or brown sugar, fruit
     A Traditional English Breakfast (a Fry-up) is what a lot of people think of when they hear breakfast here and includes foods such as sausages, beans, toast, bacon, fried eggs (that are usually still runny so you can dip your toast in the yolk, yuck!), fried mushrooms, fried tomato, hash browns, and sometimes kippers (haven't seen these offered yet) or blood sausage (sausages filled with blood that has been mixed with a filler to solidify the mixture when cooked).  Most eating establishments offer a vegetarian version with veggie sausages replacing the meat.
Brunch- ≈ Late morning meal between breakfast and lunch to replace both meals that day
     Anything goes for brunch, most places still serve breakfast or the lunch menu can kick in on the early side.  Nothing too different from brunch in the U.S.
Elevenses - ≈ 1100
     Snack foods such as biscuits and coffee
Lunch - ≈ 1200-1300
     A variety of foods such as sandwiches (one of my favourites is egg mayonnaise and cress), sometimes bread and cheese, crackers, soup and bread, pork pie (served cold), salads.  Sometimes eaten at pubs or easily transported to work.
     Sunday Lunch (or Sunday Supper) would include foods such as roasted meats, potatoes, gravy, and Yorkshire puddings, and is a somewhat formal meal.
Tea - ≈ 1600-1700 sometimes referred to as Afternoon Tea or even High Tea (later in day closer to 1800)
    Light meal of foods such as sandwiches, cakes, biscuits and tea, scones, jam and cream.
Supper- ≈ 1800-1900
    A light meal in the evening
Dinner x- ≈ 1900-2100 sometimes served as a midday meal
    Main meal of the day with foods such as roasted meat, veggies (frequently 2 vegetables are offered), potatoes, Yorkshire puddings.

While looking for some of this information I came across a couple of great websites that you may want to check out.  The one has a basic introduction to everything British for incoming students:

The other site is aimed at students and teachers:

There are days where eating so frequently is appealing but I'm too much engrained in the 3 meals a day scheme to do it very often.  There are so many great foods to eat that I'm becoming spoilt and very rarely do I miss the foods that used to be staples in America.

My husband and I are not typical foodies, he is a strict vegetarian and I am kind of wishy washy about meat, we are very happy to have the simplest of meals (soup and bread, scrounge through left overs, or pasta are all favourites).  We do have some meals that we fall back on frequently and usually keep the ingredients in stock to make a quick decision on the nights he returns from Uni. kind of late or I'm too tired to put a lot of effort into putting a meal on the table.

+ Cheese toasties and soup (we have found the most amazing cream of tomato soup in a tin here).
+ Pasta with sauce (there is one brand of sauce we love and are working our way through the varieties of flavours) sometimes we add in vegetarian meat crumbles if we want extra protein.
+ Bread, fruit and cheese (the freshness of all of these is amazing here and unlike in the U.S. it doesn't cost us an arm and a leg to have our Roman meal).
+ Sandwiches with soup if it's a dinner or with fruit or another side if for lunch (favourite sandwiches include Egg mayonnaise and Cress, lunch meat with cheese and tomato, peanut butter and jam, and just cheese and tomato sometimes).  We have a favourite bread that is perfect for making toasties but is also great for other sandwiches.
+ Bangers and mash with lots of gravy (we tend to use vegetarian sausages to make it easier to cook for us both).
+ Indian sauces with rice and vegetarian chicken pieces (there are so many choices in sauces from flavourful but mild to melt your tastebuds off, there are also at least 3 brands of ready made sauces to choose from).
+ Anything combined with chips!  Boca burgers, fishless fish fingers, chicken nuggets (veggie style of course).  The requisite condiment for chips is curry sauce, something we used to have shipped to Colorado and now can buy it no sweat in our local market.  For me chips nuked with cheese, meat and salsa is a favourite breakfast when I'm totally uninspired.

These are the offerings we keep in almost constant rotation, and since there are so many different varieties we have yet to get bored with the foods we eat (or maybe those are the nights we plan on a takeaway instead of cooking something).  I won't lie there have been foods I didn't like when I tried them here, but I keep trying new things and have expanded my food repertoire quite a bit since being here.

If there are any foods you want to try but are afraid of drop me a line and I can try to give you a personal review that may just be enough to help you give it a go.