Suicide… It’s Not About Dying !

Tonight we learned  that Robin Williams is dead, and the consistent information is that he took his own life.  Social media being what it is, there are many comments.  Most are of shock and acknowledging the incredible talent and genius of a brilliant actor and comedian; another  who is gone too soon.  There are some  comments that are just rude and clueless.  But there are also those who just don’t understand how someone could get to the point of feeling that it was just time to give up on life, that it was too painful.  That there is no hope in sight, and that the people closest to him/her would be better if he/she was just gone… Thank God most people don’t understand what it’s like to be so far down in a pit of ‘no hope’ that suicide makes sense.

Suicide isn’t as much about dying as it is about wanting the pain to stop.  The cause of the pain isn’t really that important, though addiction is often a component.  Alcohol, drugs, eating disorders, gambling, etc. are ALL ways to numb some sort of emotional pain.  I worked as an RN in drug/alcohol rehab and adolescent psych for years, and nobody ever listed death as the main reason they considered suicide.   I had a good friend (also a co-worker) who was so solid in his sobriety and recovery  when I knew him.  He became a well-known therapist in the city where we worked.  Recently, I found out that he killed himself a few years back , while  I  was searching for him online, hoping to reconnect.  He had great local resources about where to get help (including where he could get away from town for treatment).  He knew the warnings… and yet, he relapsed into drugs, and overdosed in an amount that was said to be inconsistent with an accident.   I was able to find a close friend of his who could help me fill in the blanks, enough to know that something happened to take him into that dark hole of depression and relapse. Those are never good together.

With Robin Williams, he had resources and had recently gone back to treatment for a ‘tune up’ of sorts, knowing that he was feeling a need to protect his sobriety, not that he’d relapsed  (common knowledge).  He was getting help.  None of us know what his pain was from.  We look at the professional aspect of the man and can’t make sense of what could have been so bad in his life that he decided to give up.  But even if we knew the ‘reasons’, for most, the decision to end one’s own life will never make sense.

In 1982, I was battling an eating disorder, and got to the point of feeling very overwhelmed and unable to see that things were going to get better.  I don’t remember wanting to die.  I overdosed and was in a coma for 3 days.   I was lucky to have survived, and was able to get past those feelings of just wanting to go to sleep so I didn’t hurt (in my situation, nutritional ‘rehab’ was a huge part of clearing up my thinking).  I remember taking the sleeping pills, but don’t remember ‘death’ being my goal.  I don’t remember taking the 50 antidepressants.  I don’t remember the ambulance trip, or anything else until  I woke up in ICU three days later.  At other times, always when dealing with eating disorders, I would find myself in a mindset that didn’t see an end to the overwhelming hopelessness I felt.  I would feel myself on the edge, and yet I didn’t ever want to die.  I just didn’t want to feel so much pain.  It’s an incredibly dark place to be… and there’s a feeling of loneliness that has no words to adequately describe it.  Even with people in my life, they didn’t understand what was going on in my head, and the surrounding circumstances made things more isolating.

For those that don’t understand, please be thankful that you have no frame of reference for that kind of despair.  Please look around and see if there is someone who might need a quick phone call or note to say that they matter, and to just check in to see if they’re OK.  If someone you know has changed and either seems really down, OR suddenly ‘up’ after a period of severe depression, see if they’re really OK.  When someone makes the decision to give up, sometimes they are so relieved at making the decision, that their mood improves.  That type of ‘improved’ mood (sudden) is an alarming sign.  Gradual improvement is more likely due to good treatment ( medication for the biochemical issues, and/or psychotherapy to resolve emotional pain).  Don’t be afraid to ask direct questions.   When someone approaches from concern, it’s unlikely that it will make a situation worse.

Clinical depression isn’t sadness.  It’s not about ‘reactive’ grief that many people will feel during their life when they lose a friend or family member to death, or the loss of a job, pet, or if someone moves away who had been a part of daily life.  Clinical depression is often a biochemical disruption to normal thinking and feelings.  Hopelessness and helplessness become so pervasive that the ‘normal’ way of seeing solutions to problems just doesn’t work.  While suicide is a permanent solution to temporary despair, it doesn’t feel that way to someone who finds it  worth considering.  It doesn’t feel temporary.  It’s kind of like being too far underwater after falling off of a boat, and wondering if getting to the surface is ever going to happen… like there’s no air left in life, and no ability to feel that the surface could be reached with just a couple of kicks to reach the air that restores hope. Even if getting back on the boat is a ways off, at least there would be air.  It’s like treading water UNDER water, and never getting closer to the surface.  It’s hard to withstand that type of hopelessness and helplessness for a long time, and each person has their own threshold for how long they can hold on.

People can’t snap out of it.  They can’t just go pop in a funny movie and everything is OK.  It’s a disease, that needs treatment, and  support of friends and family that understand that the person is doing the best that they can.  And when the ones who are depressed are finding themselves going further from their normal way of looking at life, they need someone who can help them hang on…

But sometimes, it just isn’t enough.   And those left to make sense of the loss  will never have a good reason to satisfy the ‘why’ questions that inevitably come up.  It definitely isn’t fair to those left behind.  And while it’s something they have to live with for the rest of their lives, it really wasn’t about them.  Sometimes, there is nothing that will redirect a tragedy.  But nothing can take away the good memories the person leaves behind… always remember the good.

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Just So Lousy… Death Is An Ugly Business

I’ve been looking back on the last year and a half, and it has become mind-boggling how many of my friends (or their close family members), family, former co-workers, and people who were part of my everyday life are now dead.  I don’t really even know where to start.

Most people know that my cousin died on March 2, 2014, so almost two weeks (tomorrow).  She had a  horrendous fight with neuroendocrine colon cancer, with every complication known to nurse-kind.  I was her ‘go to’ person (as she described me) for bouncing around ideas of what might be going on, and getting my take on what the symptoms she was having could mean.  Being eighty miles away didn’t help, but I did what I could, and my standard line was “you probably need to go to the ER” or “It would be a good idea to call your doctor now and let him/her know what’s going on.”  I was glad to be of some use- and it was also hard to know she was going through so much.

During the last twelve to eighteen months, I’ve looked up former coworkers to see if we could reconnect, and ended up finding their obituaries.   I’ve also been informed about friends’ family members- and in the case of two particular children, it was really so incredibly sad.  One died at age eleven from the same leukemia I had- less than a day after being diagnosed. Another child (8 years old) in that same extended family died from brain cancer, less than a year after she was diagnosed.  She had the best treatment there is (St. Jude’s), and she still lost the fight.  Even though their names are available on public ‘search’ links, I won’t post their names because they were minors- and I don’t have the family’s permission to name them.  I remember some kids who died when I was a kid (friend’s brother had a brain hemorrhage, kid at school had a brain tumor, skating coach’s six kids were murdered by her husband)… but as an adult, with the experience of  pediatric nursing-  hearing the screams of the parents when an infant or child died back in the Pediatric Intensive Care Unit isn’t something I’ll ever forget.  It was the most guttural, primal PAINFUL sound I think I’ve ever heard.

I am going to name a few of  the people I’ve lost in the past few years, as I have nothing but good to say about them- and they too are easily found when looking their names up.  I hadn’t expected to find their obituaries, but ….

Madeline Spenrath, R.N. was one of my nursing supervisors in Kerrville, TX.  She was one of the best supervisors I ever had anywhere.  She maintained a bit of a strict ‘ship’…but she had a heart of gold.   I reconnected with  her after her breast cancer was found, and after she’d had to have her right hip removed from the socket (along with the whole leg), as the cancer had spread.  It continued to spread, and she eventually died at one of the nursing homes I used to work at (it helped to know she was getting good care).   Madeline was ‘good people’.   She was down to earth, very knowledgable, and could get an IV into a mosquito in motion.  She had amazing BBQs for the night shift crowd every year for a long time- those were great.  She had someone tend the pit, and everyone brought a dish to pass.  She was all about team work, and it was obvious she was an amazing team leader- and player. She wasn’t above getting her hands dirty.

I had started looking for the mom and godfather of a baby I took care of for most of the first 18 months of his life when his mom worked.  I worked 2-12 hour night shifts on the weekends, and his mom worked 3-11 shifts Monday through Friday, so it was perfect.  The first 3-4 months I had him 5 days a week (had the car seat so I could get errands done), then cut back to 3 days a week so I had some time off.  But he was my little angel bug.  He’s about 25 years old now- last time I saw him he was twelve !   Anyway, when I looked up Jae Arkeen and Dana Coy, I found their obituaries.  It stunned me when I later found out that Jae had relapsed into addiction, and had elevated levels of drugs in his system that he wouldn’t have touched when I knew him.  That broke my heart. He had been SO solid in recovery.  It reinforced that ANYONE can relapse and die with drugs and alcohol.  I really don’t think he’d mind me saying that, because he’d know it could possibly reach someone who is rocky in recovery, thinking they’re invincible with their 12-Step Program.  He was the kindest, most caring guy, and thought that his godson hung the moon. He was so funny, and great to work with.  He later worked in a very intense area of counseling, and I’m sure that, along with what seems like some serious instability in his addiction recovery, was very difficult.  I had contact with  someone who had been very close to him (that I didn’t know), via e-mail, and she let me know what happened.  While it was horribly sad, there was some partial comfort in knowing it was fast- at least at the end.  I’m sure there were some painful times emotionally for him to get to that place.  I worked with him on an adolescent psych unit… he was great with those kids before he moved into a much more specialized area that is polarizing, and very difficult. He was outstanding with those kids.

Dana Coy (RN in several psych units over the years) had a very brief obituary.  brief battle with cancer.  She had been divorced from her adopted-at- birth son’s dad for years, though the son kept in contact with him- so after losing two people who were so close, I’m sure it helped to have his dad there with a long history together.  Dana and I didn’t work shifts together… but we saw each other nearly every day when she dropped the baby off (starting at 9 days old since he was adopted, so not much time off for ‘maternity’ leave), and when she’d pick him up, or I’d take him to work to do a ‘hand off’ if I was working an 11-7 during the week.  I liked Dana.  She was very easy to interact with when I took care of her son… not high strung about things, and also appreciative of having an R.N. for a regular babysitter.   I loved the baby as if he were my own.  She knew that- and also knew that I knew my boundaries as ‘the babysitter’… I always asked her before doing anything with him.  Whether it was a trip to the store, or just going to the apartment complex swimming pool, I made sure she was OK with it.

Another shock was finding out that Tricia Heath, the administrator (and an RN) at a really nice nursing home I worked at in Round Rock, TX back in the early ’90s had died. She was so supportive when I was dealing  some personal things, and was just a kind, compassionate person, who wanted the residents in that facility to have the best possible life they could in an institution.   I really cared about her, and when she and her family moved to Memphis, TN for a job her husband was offered, it was so sad to see her go.  As often happens, people say they’ll keep in touch once they get settled, and then life happens, and they’re in the wind.  Back then, there were no internet search engines for finding people, and it was all basically just luck if phone numbers were in the 411 for a particular city.  Tricia was a great administrator- she kept the place in line for state requirements, but she also had a heart.  I had a lot of respect for her.

Madeline, Jae, Dana, Tricia, and Kathy were parts of my life for a long time. Madeline, Jae, Dana, and Tricia were people I saw every day I worked, depending on the schedule I was on. I wonder how all of their families are doing.  When Facebook and other internet ‘reconnection’ things were available, it was like we’d never been away from each other. I got to catch up with Madeline the most… Jae, only once with a postcard from somewhere, and Dana only briefly when her son was twelve, and I was in Austin for a week for my work; they came up to the hotel to see me one evening when there weren’t any seminars scheduled. But it was great to see her, and how much M had grown !      Tricia was harder to track down since she’d moved back to TX.   I could have paid to find out where she was, but there was information on that thing that was really too invasive for just trying to send a ‘hi, how are ya?” kind of note.  And then they were gone.

I stopped looking for people.  I sort of don’t want to know who else is gone. If more people pop up via Facebook, or whatever, that’s great.  But I think I’m done looking.   It hurts.

Talking About Things That Hurt…

I think that for the most part, people mean well.  Even with blinding avoidance of some topics, I don’t think malice is behind what seems like apathy, or even repulsion.  My guess is that it’s more a matter of just not knowing how to approach some topics, especially if that topic is linked to some sort of instability or potential ‘trigger’ for harm.  In my life, that applies to anything related to my hospitalizations for being suicidal, or having attempted suicide (though I never really wanted to die…I just didn’t know how to get out of the pain associated with eating disorders).  It’s just not something that is covered in “Social Conversation 101”, and add a church background that repels any sort of mental pain as some type of spiritual weakness, and the doors and mouths are shut when the exact opposite is needed.

I love that I grew up in a church that was a great social and spiritual setting. The kids’ and high school programs were a lot of fun, and the place where most of my friends hung out.  I have deep gratitude for being raised in a church, and while I haven’t been to any particular building for many years (related to my job for a lot of that time, and otherwise my health limitations), my belief in God and Christianity are strong.  I’m not ‘rigid’, as is often associated with evangelicalism.  When I was growing up, the beliefs I learned were just how it was.  I then spent time as an adult reading through the Bible on my own, and found so much less judgement and hostility towards ‘non-believers’…that those who hurt are who the Bible is meant to attract, as well as give guidance to those who do believe. It’s not meant to be  a ‘weapon’ of pompous piety.  I was embarrassed at the narrow-minded acceptance parameters that I’d grown up with, and I also felt that I understood being on the ‘wrong’ side of what was acceptable.  My high school and  post-high school years were an intense period of  general unrest, eating disorders, and suicidal depression that never happened unless I wasn’t eating properly. During those years, suicide was something that came up more than once… yet I couldn’t really discuss it with anybody who knew me very well.  My parents found out I was mentioning some dark topics, and then chastised me for ever talking about such a thing; I had nothing to be all that upset about, why did I want to make THEM look bad?  All about them.  So I didn’t talk anymore. Until I got away from home.

I had worked at a wonderful church camp during the summers before my senior year in high school, freshman year of college, and half of the following summer. I’d met some incredibly caring people, and I’d disclosed a bit about the depths of despair I’d felt with the eating disorders and accompanying depression with a select few of them.  I did talk about suicide with one of them, that I remember, during a semester break when I was working at a missions conference that she attended at the University of Illinois, where I went to school.  She was also quite young at the time  (though older than I was, so I was sure she knew just about everything, being in her 20s !), and she was a major source of encouragement.  When someone is in the midst of not knowing if they even want to live, it’s not that helpful to tell them they’re not doing something ‘right’, and she didn’t do that. She did focus my thinking towards the lies in my head, and more on my/our Christian belief system.   I adore this friend to this day, and while  it  wasn’t her ‘job’ to be my counselor, she did the best she could.  Now, many years past those miserable early adulthood years, I do agree that focusing more on being what Christ wants of me, and less on the superficial things like weight  and human perception (at least how it was then) is very much what I want to do, and needed to do back then.  But as a scared, malnourished, ashamed, and depressed eighteen year old, I didn’t really get it.  But at least she talked to me at all… I didn’t feel safe talking to about %99.9 of people I knew (or didn’t know, such as therapists).  And she listened, which was ‘enough’ to help me hang on.  She gave me her time.

Sometimes,  just having something to hang on to is ‘enough’ to get through another day, and maybe that next day isn’t so bad, so it’s easier to see making it through the day after that.  I don’t think it’s a sin to have ‘negative’ emotions. I think that there can be sinful choices in how they’re handled sometimes, and I also think that there are times when people are so deep in the weeds that they need someone to look to while they try and climb back to tended ground.  I also don’t think that mental illness is a sin or sign of spiritual weakness.  It’s an illness,  and those who suffer from it (and it is suffering) are seen as being spiritually weak  in many church settings.  That is SO sad.

I can only imagine Jesus looking down at those who are hurting emotionally, and wanting those who claim to know Him to reach over and encourage and gently nudge the ones in pain so they  keep adding days to their lives until the oppressive clouds lift, and they  see daylight again.  I don’t see Jesus adding shame and judgement to someone who is already struggling to see that the next breath is worth taking.

There is a time and place for instructional discipleship, and a time and place for compassionate encouragement.  But silence in the middle of a rotating thunderstorm just doesn’t make sense.  It’s that silence that can be the last opportunity to reach out to someone who is spiraling out of control, and into a place of absolute helplessness and hopelessness, and ultimately suffocating darkness.  Even ‘just’ asking if someone wants to talk, and ‘just’ sitting with them can be enough to let them know that they matter enough to keep taking up space on the planet.  Nobody has to know all of the answers.  And it’s possible to have more questions than answers and still be a temporary rock in the middle of pain that feels like it’s going to last forever.  Being so afraid of doing something wrong that nothing is done is sometimes beyond useless. To someone who hurts, being glossed over by those who know them is worse than having something not be ‘perfectly’ helpful.  Perception in the middle of pain is often very ego-centric and inaccurate.  But a kind word in a gentle tone can ease so much.

There is nothing wrong with saying “I really don’t know how to help you, but I am so afraid for how much pain I see you in.  What can I do? I am here for you. You matter to me.”.   Having human limitations isn’t going to cause irreparable damage to someone. But apathy and inaction might.  I don’t think that anybody is ever the ’cause’ for someone else taking their own life.  If someone is resolute in their decision to at least try and end their life, they will do so. But when there are signs that something is wrong, I do believe that at least offering some human compassion and understanding can’t hurt.  And, no matter what, I’d rather know I at least tried.

 

 

Suicide Attempt: Those Who Knew Never Asked…

…why I attempted suicide in September 1982.  I later found out that it was a big secret from  family (or close friends) who seemed like they’d be obvious to inform (as in why I’d suddenly dropped off the face of the earth and was no longer at the University of Illinois, Urbana-Champaign campus).  And, for the most part, it seemed  like nobody really gave a rats tail.  I did have an uncle who had visited me at the psych hospital the semester before, God bless him.  He wasn’t afraid to see whether or not I was drooling in a corner somewhere (I wasn’t – in fact, back in those days, I was downright intact compared to many there, and it was a private facility in the days where  you either went to a state hospital – like ‘One Flew Over the Cuckoo’s Nest’- or to a private facility that was essentially a hotel with nurses and a lot of pills; there were no ‘treatment centers’).  There was the friend of another uncle who befriended me (strange situation).  But that was the extent of asking me WHY I was there.  My parents were the most silent.  Nobody ever asked me why I’d tried to end my own life.

That seems a bit odd. Maybe it was some sort of bizarre form of ‘manners’ to not ask.  But if there’s ever a scream from a mountain top that someone needs to say something about SOMETHING, it’s a premature, unnatural attempt to die. During that time, my mom was going through radiation, post-mastectomy, and I’d been dropped off at school a week early to accommodate her radiation schedule (I was fine with being at school early- though the dorms were kind of spooky without everybody there- there were about 10 of us in a 12-story dorm).  I don’t remember dealing with my mom’s cancer at all. I’d been in such a rush to ‘look normal’ after having to leave school the semester earlier… I know I’d never have wanted to ’cause trouble’.

Looking back, I’m not sure I know all of the reasons for the overdose, and only remember the first part of it when I mechanically took sleeping pills one after another with the only conscious thought being how much I just wanted some rest.  I don’t remember any actual ‘death wish’. I  ‘just’ wanted relief from so much pressure of being back on that campus after being ‘removed’ the semester before because of deteriorating anorexia, bulimia, and depression with a suicide ‘plan’ (that was pretty dang lethal).  I was trying SO hard to ‘look OK’, and that pressure was unbelievable. SO when I started taking those sleeping pills, one after another, I was only wanting relief from the pressure. I had intended to wake up, from what I remember. When I woke up after nearly 3 days in a coma, I was confused.  I also didn’t believe that they’d found the remnants of fifty antidepressant tablets when they pumped my stomach.  I don’t remember that at all. I eventually sent for the hospital and university health center records.  I needed gaps filled in.

I also wrote to my roommate years later, who told me that I’d been out at a local bar (underage), and came back to the room drunk before dinner. She hadn’t seen me actually take the sleeping pills (I do remember her being in the room, but I was sitting at my desk, my back to her; being drunk explains the impulsivity and lack of planning for consequences of my actions- and why the drugs ‘took’ so intensely). But she said I went to sleep and didn’t get up the next morning. She said I’d mumbled something about not going to class because I was so tired. When she got back late that afternoon, I was still out of it, and she couldn’t wake me up. At all.  She got one of my floor-mates from the last semester who knew me better, and she looked at me and called the ambulance (about 24 hours after taking the pills…it’s amazing that I survived that long). I was taken to the university health clinic, who sent me on to a regular medical hospital/trauma center with a blood pressure that was nearly meeting in the middle. (Not good).

In looking at the records, my ‘coma scale’ couldn’t go any lower. I responded to nothing. Zip.  And, understandably- but frighteningly, I remember none of that. I don’t know when I took the bottle of antidepressants.  I don’t remember having my stomach pumped (and used to get so uneasy later in my nursing career when OD patients were often ‘threatened’ with having their stomachs pumped as some sort of punishment; they were seen as deliberately causing unpleasant work for the ER staff who had ‘real’ patients to take care of- those who hadn’t put themselves in that position- never mind that the person was in so much emotional pain that they felt they had no other options).  I never told anybody that I planned to overdose. I don’t think I knew I would OD.   I’d been trying to fit in and be social (not something that came easily outside of my home church group setting). I wanted to be in school.

I do remember asking the nurse in ICU what I had been wearing when I was brought in, as that would tell me what day it had been. I’d been brought in on a Wednesday.  I had been wearing a red gingham shirt and overalls- I did remember putting those on on Tuesday- brought to the ER on Wednesday.  I probably looked like a dead farmer.  I was very close to not making it.  I sent for my medical records years later, and my vital signs were very bad- as in not much difference between the top and bottom numbers of my blood pressure, a heart arrhythmia, and very slow respirations.  I was given some resuscitative drugs to maintain my heart rhythm, and fluids to maintain my blood pressure, and over a few days, I woke up.  Freaked. Out.

My first recollection is of someone moving an oxygen mask to ask me a question, so they could see me talking.  Then fade to black again.  Then, I clearly remember a nurse going towards my crotch with a syringe (no explanation that she was removing the catheter). I’d never been in a real medical hospital before. From there on, it was a bunch of blips of memory, finally getting back to a ‘slow’ normal. I remember being very confused by the Saturday cartoons.  I’d been propped up in a chair with the cartoons on (at age 18?), and it was hard to follow them. Bugs Bunny was too ‘deep’. For a while, there was concern about permanent brain damage, and the psychiatrist I went back to was surprised I wasn’t impaired.  I also remember the charcoal diarrhea… I didn’t know the ‘rules’ in ICU about not disconnecting the EKG leads without help before getting out of bed ( I didn’t want to bother anybody), so it would look like I’d flatlined when I was just in a hurry to get to the bathroom.  They didn’t like that very much. I felt the bruising on my breastbone where I’d been ‘knuckle-rubbed’ to wake me up, and the scratchy feeling in my throat where tubes had been.  And it all confused me.

While I don’t remember a lot about the overall overdose, I do know I didn’t want to leave school! I wanted to do well !  I wanted to show my friends that I was OK ! (And with that, I had some desert property in the Everglades for anybody who was on board with that idea). I didn’t want to be a failure.  I have to admit, that at 18 years old, in an ICU room in Urbana, IL, I had a serious meltdown when I was told I’d be sent back to the nut farm I’d spent February through mid-April earlier that same year.  My parents had been called (that was like ramming a dagger into my heart- how could they call them? I especially didn’t want to disappoint them… but  how could they NOT call them?  I was a huge liability at that point). Everything was falling apart.  I was hysterically crying when I saw my mom and dad show up later that day (?Sunday- no cartoons, and mom had to be at radiation on Monday) after clearing out my dorm room and selling my books back to the bookstore– for some reason, losing those books was almost like the ultimate ‘proof’ that nobody believed in me… I’d been ‘removed’ from school. Again.  For weeks, I cried about that.

My therapist from the previous and current semester had been called in (she was recovering from a blood clot in her leg, and having a semi-miserable first months of pregnancy).  She explained that there were no other choices.  I couldn’t remember the overdose- that was almost worse than planning it out.  They couldn’t ensure my safety. Forest Hospital in Des Plaines, IL had already been notified, and since I was as medically stable as I was going to get, I was being discharged from the ICU to be driven back up to the suburbs of Chicago.  I was devastated.  I was horribly ashamed.  I’d failed. Again.  I didn’t see the ‘illness’ part of what was going on. I just saw failure.

It was almost a bit of a relief to be around people who knew me, who didn’t think I was a lost cause (though the next several months- September 1982 through early January 1983 weren’t exactly smooth at the hospital… I was a train wreck, and things got worse before they got better, in the days of endless insurance days inpatient; ‘losing’ school was absolutely devastating, and stirred up a lot).  I spent a total of 7 months in the hospital over 2 admissions.  I was tested (I’m reasonably intelligent, so they said- LOL) from one end to another, and I tested them. I’d always been pathologically well-behaved (confirmed years later by my folks), and at the nut farm, I blew through some rules.  I also tried to escape (going where?) and hurdled the gardner and his wheelbarrow only to collapse on the sidewalk about 1/2 a block from the hospital, in full view of a busy road…. nice to have that on my resumé. *rolling eyes*  At any rate, I was in a place to work on whatever was the immediate problem, which was making sure I didn’t blindly go on some life-ending rampage.  I was never a ‘danger to others’… it was always ‘danger to self’.  I’d give the shirt off my back to ‘others’.   Whatever had happened in that dorm room in Urbana couldn’t happen again.

In some ways I don’t know if I’ll ever know what was going through my ethanol laced brain that Tuesday afternoon when I started eating sleeping pills.  Maybe the booze was a huge part of that horrendous time.  It does explain a lot- but there had to be enough going on to ‘set up’ what happened.  What I did.  The memory loss has always been really hard to deal with. There are days that are just ‘gone’.  No matter how hard I try to figure it out, it’s just not there.  But I always wondered why nobody asked me if I’d really wanted to die.  The answer is no.

Answering “Search Engine” Questions…

When I look at my site stats, I see the search engine topics that people are using to find information…. I’m using this post to answer some of those questions, in hopes of helping folks a bit ❤  I will edit at times to add more information as I see new topics.

Today, I saw a search for leg pain and leukemia M-3….  I do remember leg pain, with the chemo.  Several of the medications used had musculoskeletal pain as a side effect. ATRA and I think arsenic can cause pain.  I had more pain as the year of maintenance went on- I was on ATRA, methotrexate, and M6 mercaptopurine at the time.

I also saw a search for diabetes and chemo- my blood sugars went nuts when I was on chemo. They’re just now getting back to some sort of normal range.  It took several months and a trip to a Joslin affiliated endocrinologist for some insulin and metformin adjustments.

I just saw a search for ‘what could have gone wrong in the ER when someone dies from leukemia there’…. well, some leukemias are known for being really bad for causing ‘bleeds’ – sometimes in the brain (can be fatal very quickly), and sometimes in other parts of the body that can be really significant before they’re detected.  Also, leukemia is known for not protecting the body from infection- so someone could have a really bad infection and not be able to fight it- but if they didn’t know they had leukemia, they might not get help until the body couldn’t keep going (septic shock).  Leukemia can show up in ERs for the first time. Sometimes, the only time it shows up is during an autopsy.  😦

As far as people dying from APL in this day and age, yes. It happens. I know of 2 people in the last 6 weeks who died within 2 days of being diagnosed.  Because the blood clotting cells (platelets) are very low with APL when it is diagnosed, there is a huge risk for severe, and possibly fatal hemorrhages in the body or brain.  Those can be lethal very quickly.  APL also causes impaired ability for the body to fight infections. That can also cause death.  I was lucky to be diagnosed in time; some people are diagnosed at their autopsies.  But I was also very sick.  I got infections, and also tiny purple spots all over my legs and abdomen from low platelets. I got 13 platelet transfusions and 12 blood transfusions.   If APL isn’t treated it IS fatal. End of story.  If it is treated, but the disease is too advanced, or infections are too severe, death is a very real possibility. As an RN, I understood what was happening to me, but I was too worn out to really pay much attention…but I was SICK !!

If someone goes to the emergency room with advanced APL, it is VERY possible that the ER didn’t do anything wrong.  The disease was simply too advanced.  If someone goes to the ER because of severe headaches or decreasing level of consciousness (or coma), the brain bleed has already happened.  The ER is NOT the place for APL to be treated. They can identify lab work that indicates the probability of some type of leukemia, but it takes a bone marrow biopsy and specialized testing in specific labs (often not in the actual hospital since it is SO specific) to determine the type of leukemia. But the most an ER can do is identify the probable problem, and send the patient to the proper part of the hospital for complete diagnosis, and specific treatment.

Another search engine term I’ve seen more than once on my site stats involves defining what a ‘frequent flyer’ is in regards to an emergency room.  ERs consider someone to be a frequent flyer if they are in the ER a lot, and often if they are either looking for pain medications OR don’t have a primary doctor of their own. Frequent flyers are not regarded well by ER staff.  Most of the time (not always) the frequent flyers go to the ER for things that aren’t actual emergencies.  Many also visit several local ERs to either get meds or see a physician for something that is really not appropriate to have cared for in an ER.  They waste resources in many cases. They cost a lot of money (many also don’t have insurance).  SOMETIMES, the ER really doesn’t have a clue why someone is in their ER- they make judgements about the person that aren’t true.  But in most cases, frequent flyers are there because they made the decision to go to the ER and seek some sort of ‘care’.

For : ‘If I’ve had leukemia for over 3 years is it too late to fix this?”- it really depends on the type of leukemia- if you’ve had it for that long and hadn’t been diagnosed or treated, it sounds like a slower chronic form (if you have leukemia at all– there are other things that can have similar symptoms)- whether it’s myelocytic or lymphocytic requires specific testing.  It’s not over until it’s over !  See your doctor, and get it checked out 🙂

Whoever is entering ‘two nurses having sex’, ‘nurses sex’, ‘nurse sex’, or other inappropriate terms into the search engines- GET HELP.   It’s repulsive to have some pervert finding my posts.  If you wonder how two nurses have sex, they don’t have any special parts.  If you want some twisted porn site, then go to ‘porn’, and look there. GO AWAY.   Geez- you’re at it every. damn. day.   Get a magazine and go deal with yourself.

How to pronounce the Swedish cheese bondost spelled Bond Ost…. in English, it comes out like this :  Bónd Oost.  The ‘bond’ is more like booned. But not as long with the o’s.  If that makes sense- LOL.  😉

As far as recipes for Swedish sylta- there are some great Swedish recipes if you just enter exactly what you did…. how to make Swedish sylta.  I personally don’t like veal jello 🙂

For the person asking about the schnauzer waking up gasping and breathing heavily- and why dogs hold their heads up to breathe when they have heart failure :  The dogs’ hearts aren’t pumping oxygenated blood effectively, so they gasp to get more air… they hold their heads up because sometimes the heart becomes so enlarged (I saw my dog’s chest x-ray- it’s dramatic) it actually shifts the windpipe, and it’s ‘bent’.   Medications and prescription diets can help- one of my dogs made it 12 GOOD months. My dog who died 10 days ago made it about 9 months or so.

“Roof of my mouth is smoothed out”….. that happened to me when I got the induction chemo for APL (leukemia).  It went back to normal within a month or so after the last day of the induction chemo, and the consolidation and maintenance did not have that effect on my mouth.

A really important search engine term today:  ‘In ‘mission’ (remission) from APL leukemia for a year so won’t relapse’…. YES- you CAN relapse- that is why follow-up care is so important !  You didn’t go through all of that chemo for nothing !!  Keep following up with your oncologist !  You can relapse at any time, though my understanding is that after 5 years of CONTINUOUS remission, you are considered ‘permanent remission’ or cured.

To the bulimic who ‘pucked up blood clots’…. GO TO THE EMERGENCY ROOM.  Your esophagus could be tearing, which is fatal if not treated.  No joke. Get yourself seen by a doctor.  Suck it up, and get some help ❤  It’s scary, but you seriously could be getting ready to blow your esophagus (or stomach) and bleed to death.

OK…. here’s a favorite one (and it’s from today !!)  ‘witch side of the syringe is the cc side’ (sic)…  Here’s a tip. If you don’t know, put the syringe DOWN !!  If you’re in some sort of training to learn to use them, they will tell you.  If you have a legitimate reason for handling syringes, there is someone to ask- and it’s a valid question. But to ask that in a search engine search bar tells me something isn’t quite right, possibly !  🙂

To the person who entered “can you get disability for not being able to wipe your butt?” in the search engine, how about this- with that level of dumb ass you might just qualify.  Disability isn’t a joke. You, however, are.  Do you have any idea what being disabled actually means?  Do you have any human DNA? Or are you just so mentally disturbed that you don’t care?   If the lack of ability for personal hygiene is part of an actual disorder, then maybe…. just maybe you (or whoever) would qualify. Go ask someone who might know your situation, and quit looking up offensive topics.  OR play in traffic – the results of that may land you on disability.

Edit:  I guess I was annoyed that day 😮   Disability still isn’t a joke, and is a demeaning place to end up.  It’s not a career destination.  😦    I miss working every single day.  I miss feeling useful.  I miss having a sense of purpose.  I miss taking care of patients.  And, I even miss the idiots 😉

Friends Who Cross the Line: Suicidal vs. Drama Junkie

I had a coworker one time who initially seemed to be a ‘normal’ everyday person and LVN (licensed vocational nurse).  I got to know her family, and we worked well together.  She was supportive of me when I had been going through some of the eating disorder stuff.  For several years, the friendship was close and the boundaries weren’t dysfunctional.  We were friends- not mutual ‘therapists’.

Then she started going through some things that I was in no way equipped to deal with. It’s one thing to be supportive, but it’s quite another to be asked to participate in the chaos.  I’d visited her in the hospital when she decided she was going to have an eating disorder and was being tube fed (she had never had a history of eating disorders until her late 30s- possible, but not the usual age for first onset).  I encouraged her during ‘recovery’.  There was an awful lot of work she put into having an eating disorder that was unlike anybody else I’d ever seen in my years of eating disorder treatment; I probably saw a few dozen ED patients during those times…’P’ made it her life’s work.  Not something that was controlling her thoughts. It’s hard to explain- but it was different.  She recovered when she got tired of Slim Fast.  She sort of stablized out, and resumed her life as a nurse, mom, and wife.

Then one day, she called me and asked if she could come over to my apartment.  I told her it was fine, though I was rather preoccupied taking care of a nine day old baby- he’d been adopted by a coworker at my then current place of employment, and I was the designated babysitter while she was working. I wanted to be fully attentive to him, as well as knowing that his mom would be calling to see how he was doing. Because he was adopted she didn’t have the maternity leave of several weeks.  Anyway, ‘P’ came over. She walked in and asked me if I’d tell her kids that she loved them; she was going to kill herself.  I was instantly livid.

I’d dealt with suicidal coworkers and patients before.  Professionally, I knew the resources that were available, and who I needed to contact.  On a friendship level, I was outraged that she even thought that what she was asking was OK.  I had a newborn in my arms, and a crazy person in my living room.  There was no question whose best interest I was looking after. I told ‘P’ “sure, I’ll tell them”, and I escorted her to her car, got her license plate number, and called the police.  I then called her psychiatrist who told me I was the third or fourth person to let him know she was running around telling people she was suicidal.  That made me even more angry- but I’d notified the proper people. She was their problem.

I’m not insensitive to suicidality- not at all.  I’ve been there.  I’ve overdosed to the point of being comatose for three days, waking up in ICU and not knowing what was going on. I still don’t remember wanting to die.  I remember being overwhelmed, but not wanting death to be the outcome.  I know the internal struggle to find some way out of intense emotional pain. But this was different.  I don’t think that the vast majority of suicidal people are ‘crazy’…not by a long shot. This was behavior that is SO indicative of borderline personality disorder, which is an extremely difficult disorder to deal with.  The hot-cold, sick-well, black-white thinking and actions are exhausting.  The person is in legitimate psychological pain- and they spread it around whether they mean to or not.

There is no healthy relationship with someone who is a borderline…other than to back away and leave that part of their life to the professionals.  Folks with BPD create crises in their lives, and involve whoever they deem to be on their ‘good list’ (that week).  If there is some sort of perception of that person not seeing things their way, then they’re on the ‘bad list’.  And it flip-flops all the time.  Working with borderlines was tiring enough when I was getting paid for it; having one outside of work involved in my life wasn’t going to happen when it got to the point of her ‘playing’ with suicidal comments.

I got a message on my answering machine later that night saying that she was sorry to have upset me, and that the police were there when she got home from my apartment.  I never had voluntary contact with her again. She did surface at a nursing home I worked at, but quit after a couple of weeks: no call-no show. I was asked by my employer what I thought about ‘P’… she was a good nurse, but her personal life was a train wreck (she had a LOT of unresolved childhood trauma issues- which I did hope she got help for, but she didn’t need to be responsible for nursing home residents)…. I just said that I’d always thought her penmanship was really good.  I wasn’t going to tell them about the psychological issues   since she wasn’t still working there.  Had she continued to be in charge of elderly patients, I’m not sure I would have had a choice but to report her instability due to the rules of the Texas Board of Nurses. And yet, she had never let her patients suffer… she was a good nurse. It was iffy territory.   It wasn’t fair for her to put me in that position.  I’m a loyal friend until someone plays with crisis situations as if they were games.

I’ve thought about ‘P’ over the years, and hope she found some peace and was able to work through the things in her early life that were genuinely horrible.  She was in a lot of pain, and had some tragic things happen with one of her three kids.  I’ve wished the best for her and her family. The last I heard, she and her husband that I knew divorced (a borderline wife would have been really hard), and she’d remarried.  That was at least 20 years ago.  I hope she found some sort of calm in her life, and a realization that she didn’t need to create chaos for people to care about her. She had some wonderful qualities.  But she was in so much pain…it was more than a friend could handle with any sort of healthy boundaries.

The Designated Nut At Age Eighteen

As a result of anorexia and the depression I only experienced during periods of starvation, the university I was attending decided I wasn’t safe staying on campus. I was to be sent to a psychiatric hospital near Chicago.  It no longer exists, but my memories sure do.

It was February 1982, and I was falling apart.  The eating disorder and coinciding mood swings were making university life and class attendance nearly impossible.  I was horrified that I couldn’t just make it work.  I had some suicidal thoughts, and the means to carry them out , as I’d discussed with the therapist I’d been seeing as a condition of staying at the University of Illinois (they found out about the anorexia very early in the first semester in the fall of 1981). She didn’t want to take any chances.  I’m sure that the fact that I was talking more had to be somewhat alarming, since I’d said little besides “I don’t know” to anything she’d asked since first meeting me in September of 1981.  I didn’t have much choice- either voluntarily admit myself to a psychiatric hospital, or be committed.  I was horrified and ashamed, which wasn’t helping anything.   I agreed to go to the hospital near Chicago, but only if my parents were NOT the ones who drove me there.  Arrangements were to be made, but in the meantime, I was taken to the university health center and kept for observation.  Nifty way of saying they didn’t trust me, and weren’t sure I wasn’t going to kill myself.  The therapist had the university fire department drive me over there.  Subtle.

I didn’t really want to die. I just wanted the pain to stop and I hadn’t found any way to make that happen.  I was 18 years old, and didn’t have the life skills to know that the bad times don’t last forever, and the eating disorder that made most anything ‘logical’ impossible was driving a lot of my thinking.  So I was to stay at the inpatient clinic until the plans were arranged.  I’d asked for a specific family friend to drive the 200 miles to come and get me, and then take  me the 170 miles or so to the hospital.  That’s a lot to ask, but she agreed.  Then it got complicated.

In February 1982, central Illinois got hit with a blizzard, and the arrangements to pick me up had to be postponed until the roads were cleared, and it was safe to travel.  If I remember right, it took about 3-4 days.  During that time, my dorm friends came to say goodbye.  It was sort of surreal.  My brain was so starved that not much really sank in.  I knew what was happening, but at the same time,  I had no idea about what  type of place I was going to be admitted .   The only type of psych hospitals I’d seen were those on TV, and the accuracy of those was questionable.  Finally, the weather cleared enough for me to be picked up by my friend and her daughter (who I also know and like- I still know them), and I was taken to the hospital.

I was mortified to see my parents in the lobby. I was so ashamed that I’d failed to just pull it together. They had to be there to sign the insurance forms and admissions papers for billing, but I also had to sign myself in since I was ‘of age’.  I was the youngest person on the adult unit.  And in for a real education.

My psychiatrist (assigned at random) ‘banned’ my parents from contacting me for at least a month. He let them know if I was doing OK.  He wanted to get to know me, and find out why I didn’t want them to pick me up in Urbana (shame). He also wanted me to learn to let loose a little bit; I was too restrained and worried about what other people thought.  He asked my folks to send $100 (worth a lot more in 1982 than it is now- though still a nice chunk of change) so I could go to K-Mart and get some overalls (something my mom refused to let me wear) and have some fun shopping with one of the psych techs who monitored us nuts on the unit.  My mom never let me go to K-Mart (it hadn’t spiffed itself up at that point; afterwards, she didn’t mind it).  I was to be dressed in name brand clothing (preferably stuff that made The Preppy Handbook… I’m not kidding). Marshall Field’s & Co. was HER preferred place to get my clothes. I hated that store when I was growing up.  Too much foo foo.

I was the designated ‘nut’ in the family, but no member of any family gets to the point of needing psychiatric hospitalization for eating disorders (or anything else) in a vacuum. In the early 80s, eating disorder treatment was in its infancy.  Nearly all ED patients were put on general psych wards, and the stigma went with that.  I didn’t find out how bad that stigma was until much later when I found out that my folks never told anybody where I was.  I just ‘wasn’t’ at the U of I.  Enter a void in time and place regarding my existence. My mom’s ‘baby’ brother came to see me, so he’d found out.  I’m still not sure how.  It doesn’t mean that my immediate family was some raging psycho farm, but something wasn’t OK.  Sometimes it’s perceived, and sometimes it’s actual dysfunction- but the end result is actual dysfunction for somebody. When I got older and worked as an RN in a psych hospital with adolescents, I saw it all the time.  The family needed someone to direct their troubles at.  The kids are easy targets- and often are acting out in some way because of the dysfunction.

My mom was not a warm type of mom.  Even the social worker caught on to that during the one  interview with my folks.  My mom wasn’t ‘evil’ or ‘bad’-she just had her own stuff.  She and my dad had both lost newborn sons about two years apart from the same disease, before they were 25 and 29 years old (roughly).  That’s pretty young to deal with such loss. Dad turned to work, and mom just shut down.  Now, they’d be offered counseling without that being seen as ‘weak’ or ‘defective’ (as therapy often was up until, and through, my treatment for anorexia).  It just wasn’t done by ‘normal’ families.  So a lot of hurting people were stuck in their pain, alone.  My mom wasn’t in a place to be nurturing a baby when she was terrified something would happen to me, and she stayed at a distance to protect herself. It wasn’t about me.  She was in pain.

Anyway, I was at the hospital for about 3 1/2 months that first admission.  I did better, but eating disorder treatment didn’t address the core issues of self-worthlessness and overall loathing of taking up space on the planet.  That wasn’t about dying either.  It was about feeling like  I just shouldn’t ‘be’.  It took many years to get to the core reasons I was so self-destructive via the eating disorders.  It made me the designated family crackpot.  That seemed handy, and it was a big secret to anybody outside of our home and very close family; I’m still not sure most of them ‘know’.  I’m not proud of it, but keeping things secret just perpetuates disorder.   NO family gets through this life without something dysfunctional going on.   Everybody has stuff.  It hurts less when it doesn’t seem to be so shameful.